Ageless Women'S Health Id LLC

Organization Active NPI Adult Medicine Physician · Meridian, ID

NPI 1235975202 · NPPES record last updated Jul 8, 2024

Key facts

NPI
1235975202
Entity type
Organization (NPI type 2)
Primary specialty
Adult Medicine Physician 207QA0505X
Legal business name
AGELESS WOMEN'S HEALTH ID LLC
Practice address
3875 E Overland Rd Ste 108
Meridian, ID 83642-9047
Phone
(208) 268-5592
NPI assigned
Jul 8, 2024
Organization subpart
No

Authorized official

Name
Teah Phillips
Title
Credentialing Manager
Phone
(901) 205-3999

National Provider Directory

Locations

3875 E Overland Rd
Ste 108
Meridian, ID 83642
Phone (208) 297-5829

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QA0505X Yes

Addresses

Primary practice location

3875 E Overland Rd Ste 108
Meridian, ID 83642-9047

Mailing address

3875 E Overland Rd Ste 108
Meridian, ID 83642-9047

Other providers in Meridian, ID

All providers in Meridian, ID · Adult Medicine Physician in Idaho

Sources for this page

Verify at the official NPI Registry.