Provider Demographics
NPI:1548811441
Name:CATALYST ACUPUNCTURE & INTEGRATIVE MEDICINE
Entity type:Organization
Organization Name:CATALYST ACUPUNCTURE & INTEGRATIVE MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-906-1441
Mailing Address - Street 1:4477 W EMERALD ST STE A150
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-2027
Mailing Address - Country:US
Mailing Address - Phone:208-906-1441
Mailing Address - Fax:
Practice Address - Street 1:4477 W EMERALD ST STE A150
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2027
Practice Address - Country:US
Practice Address - Phone:208-906-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center