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1659365575
SKY R BLUE
BOISE, ID
NPI
1659365575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RI0200X Internal Medicine, Infectious Disease
(Licence: ID M7398)
Enumeration Date
2005-09-07
Last Update Date
2007-07-08
Business Address
-- SKY R BLUE M.D.
125 E IDAHO ST SUITE 203
BOISE, ID 83712-6212
Phone number: 208-338-0148
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Mailing Address
-- SKY R BLUE M.D.
125 E IDAHO ST SUITE 203
BOISE, ID 83712-6212
Phone number: 208-338-0148
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