Organization Name: | BOISE PAIN MANAGEMENT |
NPI Number: | 1871856047 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL JOSEPH PLYER (NCTMB) |
Mailing Address: | 8950 W Emerald St Ste 150 Boise |
State: | ID US |
Postal Code: | 837048296 |
Phone Number: | 2083764571 |
Fax Number: | 2083764621 |
NPI Enumeration Date: | 06/21/2012 |
NPI Last Update Date: | 06/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 155194-00 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |