Individual
CAROLYN COX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-7340
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
(520) 323-4350
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-1058
ID
133V00000X
Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148906
—
AZ
Enumeration date
05/25/2007
Last updated
05/30/2023
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