Individual
REBECCA GREENWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, MACOM
Contact information
Practice address
9450 W FAIRVIEW AVE STE 120, BOISE, ID 83704-8179
(209) 292-1374
Mailing address
9450 W FAIRVIEW AVE STE 120, BOISE, ID 83704-8179
(209) 292-1374
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU380
ID
Other
Enumeration date
09/19/2020
Last updated
09/19/2020
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