NPI 1144341637

The Pediatric and Adolescent Center, INC.

Organisation Legal Medicine Boise, ID

Practice location

Address: 6148 N Discovery Way Suite 100, Boise, ID 83713-0201
Phone: (208) 322-5437
Fax: (208) 322-6013

Authorised official

Name: William Sullivan Bourquard
Title: Owner
Phone: (208) 322-5437

Registered specialties

Legal Medicine Primary

Other Service Providers Taxonomy 173000000X Licence M-5223 (ID)

Other Legal Medicine providers in Idaho →

Registry record

NPI: 1144341637
Entity type: Organization
NPI issued: 2 Apr 2007
Record last updated: 22 Aug 2020

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.