Individual
CHRIS BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12652 S AREZZO WAY, NAMPA, ID 83686-8276
(208) 709-5513
Mailing address
4300 E FLAMINGO AVE, NAMPA, ID 83687-3138
(208) 205-3013
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
O-1870
ID
Other
Enumeration date
04/08/2020
Last updated
12/08/2023
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