Healthcare Provider Details

I. General information

NPI: 1275755449
Provider Name (Legal Business Name): PAUL EVERETT STRINGER TCM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 02/03/2023
Certification Date: 02/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11639 W GINGER CREEK DR
BOISE ID
83713-3654
US

IV. Provider business mailing address

11639 W GINGER CREEK DR
BOISE ID
83713-3654
US

V. Phone/Fax

Practice location:
  • Phone: 801-458-8232
  • Fax:
Mailing address:
  • Phone: 801-458-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: