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1801567029
ADD CLINIC OF IDAHO
MERIDIAN, ID
NPI
1801567029
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Entity Type
Organization
Authorized Contact
CODY D MATTINGLY
Owner
858-207-8861
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2021-09-27
Last Update Date
2021-09-27
Business Address
ADD CLINIC OF IDAHO
1450 W USTICK RD UNIT 102
MERIDIAN, ID 83646
Phone number: 858-207-8861
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Mailing Address
ADD CLINIC OF IDAHO
330 W ANTON DR
MERIDIAN, ID 83646-2066
Phone number: 858-207-8861
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