| Organization Name: | PREVENTATIVE HEALTH |
| NPI Number: | 1922377027 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIELLE BENNION (OWNER) |
| Mailing Address: | 9171 W State St Boise |
| State: | ID US |
| Postal Code: | 837141733 |
| Phone Number: | 2088532273 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2011 |
| NPI Last Update Date: | 01/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |