Individual
VALERIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
LRT-1383
ID
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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