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1720187289
BARRY JUSTIN CUSACK
BOISE, ID
NPI
1720187289
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RG0300X Internal Medicine, Geriatric Medicine
(Licence: ID M5678)
Enumeration Date
2006-09-21
Last Update Date
2007-07-08
Business Address
Dr. BARRY JUSTIN CUSACK MD
500 WEST FORT ST (111)
BOISE, ID 83702-4598
Phone number: 208-422-1000
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Mailing Address
Dr. BARRY JUSTIN CUSACK MD
9550 CHELAN AVE
GARDEN CITY, ID 83714-1264
Phone number: 208-375-8560
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