Brook Medical PLLC
Family Medicine in Eagle, ID. Organization (NPI-2).
NPI number1053494146
StatusActive
Last updated in NPPESFeb 10, 2015
Details
- NPI
- 1053494146
- Entity type
- Organization (NPI-2)
- Legal business name
- Brook Medical PLLC
- Organization subpart
- No
- Enumeration date
- Oct 23, 2006
- Last updated
- Feb 10, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Eagle Creek Family Medicine (Doing Business As)
Practice location
1281 E. Iron Eagle DrEagle, ID 83616-9117
Phone 208-939-5535 · Fax 208-939-5536
Mailing address
1281 E. Iron Eagle DrEagle, ID 83616-9117
Phone 208-939-5535 · Fax 208-939-5536
Authorized official
Vicki L Wooll
Owner
2089395535
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