NPI 1295420651
Mind and Body Restored
Practice location
- Address
- 913 W Canfield Ave, Coeur D Alene, ID 83815-9764
- Phone
- (208) 957-7808
- Fax
- (949) 695-2456
- Mailing address
- 3117 W Augustin Dr, Coeur D Alene, ID 83815-5362
Authorised official
- Name
- Jana Quall
- Title
- NP
- Phone
- (208) 957-7808
Registered specialties (2)
Pain Medicine Physician
Primary
Addiction Medicine (Family Medicine) Physician
Registry record
- NPI
- 1295420651
- Entity type
- Organization
- NPI issued
- 10 Apr 2023
- Record last updated
- 5 Dec 2023
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.