Organization
WEST VALLEY PROFESSIONAL FEE BILLING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY MOORE (CEO)
(208) 459-3718
Entity
Organization
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 455-3707
Mailing address
PO BOX 404091, ATLANTA, GA 30384-4091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
ID
207R00000X
Internal Medicine Physician
Primary
—
ID
2084N0400X
Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80626800
—
ID
05
—
806826900
—
ID
05
—
806827000
—
ID
Enumeration date
06/13/2006
Last updated
08/12/2008
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