PENNY MICHELLE FAIRES

BOISE, ID
NPI1700827508
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  MR0824)
Enumeration Date2006-06-10
Last Update Date2007-07-08
Business Address
Ms. PENNY MICHELLE FAIRES M.D.
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-367-6030
Mailing Address
Ms. PENNY MICHELLE FAIRES M.D.
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-367-6030