NPI 1164121562
Gunnar Harrison Maughan, MSPOCPO
Practice location
- Address
- 9632 W Emerald St, Boise, ID 83704-9762
- Phone
- (208) 866-5177
- Mailing address
- 130 W River Heights Dr, Meridian, ID 83646-5120
Registered specialties (2)
Prosthetic/Orthotic Supplier
Primary
Durable Medical Equipment & Medical Supplies
Registry record
- NPI
- 1164121562
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 24 Feb 2023
- Record last updated
- 24 Feb 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.