ADD CLINIC OF IDAHO

MERIDIAN, ID
NPI1801567029
Entity TypeOrganization
Authorized ContactCODY D MATTINGLY
Owner
858-207-8861
Organization Subpart ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
Enumeration Date2021-09-27
Last Update Date2021-09-27
Business Address
ADD CLINIC OF IDAHO
1450 W USTICK RD UNIT 102
MERIDIAN, ID 83646
Phone number: 858-207-8861
Mailing Address
ADD CLINIC OF IDAHO
330 W ANTON DR
MERIDIAN, ID 83646-2066
Phone number: 858-207-8861