Renu Medispa | |
951 E Plaza Dr Suite 150 Eagle ID 83616-6566 | |
(208) 939-4456 | |
(208) 287-2200 |
Full Name | Renu Medispa |
---|---|
Speciality | Clinic/center |
Location | 951 E Plaza Dr, Eagle, Idaho |
Authorized Official Name and Position | Tawni Weaver (DIRECTOR) |
Authorized Official Contact | 2089394456 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Renu Medispa 951 E Plaza Dr Suite 150 Eagle ID 83616-6566 Ph: (208) 939-4456 | Renu Medispa 951 E Plaza Dr Suite 150 Eagle ID 83616-6566 Ph: (208) 939-4456 |
NPI Number | 1407129125 |
---|---|
Provider Enumeration Date | 02/10/2012 |
Last Update Date | 04/30/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407129125 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | NP784A (Idaho) | Primary |
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