ALLISON BROOKE BASTIAN

BOISE, ID
NPI1164862058
Former NameALLISON BROOKE OWENS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  M-12732)
Additional Taxonomies207Q00000X Family Medicine
(Licence: ID  MRM-1333)
Enumeration Date2013-06-25
Last Update Date2017-01-25
Business Address
-- ALLISON BROOKE BASTIAN MD
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-514-2500
Mailing Address
-- ALLISON BROOKE BASTIAN MD
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-514-2500