Organization
BOISE PODIATRY CLINIC, P. A.
Active
Other names
Podiatry Center of Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY J MILLWARD DPM (ADMINISTRATOR)
(208) 938-4670
Entity
Organization
Contact information
Practice address
6051 N EAGLE RD, BOISE, ID 83713
(208) 938-4670
(208) 938-4675
Mailing address
6051 N EAGLE RD, BOISE, ID 83713
(208) 938-4670
(208) 938-4675
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
12/11/2007
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