NPI 1023053204

Glen S Lovelace MD PA

Organisation Specialist Boise, ID

Practice location

Address: 333 N 1st St STE 260, Boise, ID 83702-6132
Phone: (208) 345-3136
Fax: (208) 345-0984

Authorised official

Name: Glen S Lovelace
Title: Owner
Phone: (208) 345-3136

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence M6570 (ID)

Other Specialist providers in Idaho →

Registry record

NPI: 1023053204
Entity type: Organization
NPI issued: 19 Jun 2006
Record last updated: 1 Jun 2009

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.