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1750337978
PEDIATRIC NEUROSURGRY OF IDAHO PC
BOISE, ID
NPI
1750337978
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Entity Type
Organization
Authorized Contact
WALTER BRUCE CHERNY
Owner
208-381-7360
Organization Subpart ?
No
Primary Taxonomy
207T00000X Neurological Surgery
(Licence: ID M8385)
Enumeration Date
2006-05-26
Last Update Date
2008-05-26
Business Address
PEDIATRIC NEUROSURGRY OF IDAHO PC
100 E IDAHO ST
BOISE, ID 83712-6270
Phone number: 208-381-7360
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Mailing Address
PEDIATRIC NEUROSURGRY OF IDAHO PC
6140 CURTISIAN AVE SUITE 400
BOISE, ID 83704-8880
Phone number: 208-367-3500
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