TABLE ROCK MOBILE MEDICINE PLLC

MERIDIAN, ID
NPI1194186437
Entity TypeOrganization
Authorized ContactBRADLEY BIGFORD
Sole Member
986-224-8420
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: ID  NP-1252A)
Enumeration Date2016-03-15
Last Update Date2024-05-11
Business Address
TABLE ROCK MOBILE MEDICINE PLLC
3090 E GENTRY WAY STE 210
MERIDIAN, ID 83642-3550
Phone number: 986-224-8420
Mailing Address
TABLE ROCK MOBILE MEDICINE PLLC
PO BOX 44953
BOISE, ID 83711-0953
Phone number: 986-224-8424