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General NPI Number Information
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NPI Number | 1972545762
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Entity Type | Organization
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Legal Business Name | WEST VALLEY PROFESSIONAL FEE BILLING, LLC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 1717 ARLINGTON AVE
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City | CALDWELL
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State | ID
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Zip | 83605-4802
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Country | US
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Telephone | 208-455-3707
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 404091
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City | ATLANTA
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State | GA
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Zip | 30384-4091
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. KATHY MOORE
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Credential |
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Telephone | 208-459-3718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | ID
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