Organization
REHAB SYSTEMS BOISE LLC
Active
Other names
Coyote Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
COLETTE BROWN (ADMIN MANAGER)
(208) 342-4104
Entity
Organization
Contact information
Practice address
427 N CURTIS RD, BOISE, ID 83706-1439
(208) 342-4104
(208) 342-4106
Mailing address
427 N CURTIS RD, BOISE, ID 83706-1439
(208) 342-4104
(208) 342-4106
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147985
BLUE SHIELD OF IDAHO
ID
05
—
002728201
—
ID
01
—
8J604
BLUE CROSS OF IDAHO
ID
Enumeration date
07/12/2005
Last updated
06/09/2025
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