NPI 1023024684
Center for Pain Care P a
Practice location
- Address
- 115 W Main St Suite 102, Boise, ID 83702-7302
- Phone
- (208) 342-4700
- Fax
- (208) 342-4710
Authorised official
- Name
- Clinton Mallari
- Title
- Administrator
- Phone
- (208) 342-4700
Registered specialties
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
Registry record
- NPI
- 1023024684
- Entity type
- Organization
- NPI issued
- 1 Aug 2006
- Record last updated
- 19 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.