NPI 1154345585

Clinton Mallari, MD

Practitioner Pain Medicine (Physical Medicine & Rehabilitation) Physician Boise, ID

Practice location

Address: 115 W Main St Suite 102, Boise, ID 83702-7302
Phone: (208) 342-4700
Fax: (208) 342-4710

Registered specialties

Pain Medicine (Physical Medicine & Rehabilitation) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2081P2900X Licence M6287 (ID)

Other Physical Medicine & Rehabilitation providers in Idaho →

Registry record

NPI: 1154345585
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jul 2006
Record last updated: 9 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.