Individual
MEAGAN BOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST # 111R, BOISE, ID 83702-4599
(208) 422-1314
(208) 422-1388
Mailing address
500 W FORT ST # 111R, BOISE, ID 83702-4599
(208) 422-1314
(208) 422-1388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
390200000X
ID
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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