MAIN STREET MEDICAL LLC

BONNERS FERRY, ID
NPI1134274103
Entity TypeOrganization
Authorized ContactCHUCK NEWHOUSE
Owner
208-265-3655
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  M-7989)
Enumeration Date2007-01-23
Last Update Date2008-02-22
Business Address
MAIN STREET MEDICAL LLC
6641 KANIKSU ST SUITE A
BONNERS FERRY, ID 83805-7532
Phone number: 208-265-3655
Mailing Address
MAIN STREET MEDICAL LLC
PO BOX 1640
BONNERS FERRY, ID 83805-1640
Phone number: 208-265-3655
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