| Organization Name: | BOISE VALLEY DOCTORS, P.A. |
| NPI Number: | 1578741393 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALLEN ROGER NEUENSCHWANDER (CEO) |
| Mailing Address: | 6000 W Overland Rd Boise |
| State: | ID US |
| Postal Code: | 837093013 |
| Phone Number: | 2083237588 |
| Fax Number: | 2085153468 |
| NPI Enumeration Date: | 02/04/2008 |
| NPI Last Update Date: | 12/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | M-2852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |