NPI 1316243371

Treasure Valley Colon & Rectal Clinic PLLC

Organisation Colon & Rectal Surgery Physician Boise, ID

Practice location

Address: 1072 N Liberty St Suite 201, Boise, ID 83704-8706
Phone: (208) 377-2273
Fax: (208) 367-3059

Authorised official

Name: Johnny B Green
Title: President
Phone: (208) 377-2273

Registered specialties (2)

Colon & Rectal Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208C00000X Licence M11186 (ID)

Other Colon & Rectal Surgery providers in Idaho →

Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence M11186 (ID)

Other Surgery providers in Idaho →

Registry record

NPI: 1316243371
Entity type: Organization
NPI issued: 8 Feb 2011
Record last updated: 22 Mar 2011

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.