Timothy Mavy

NPI 1275940108 · on the registry since 2014 · sole proprietor

Practice

Address: 5513 N Glenwood St
Boise, ID 83714
Phone: (208) 375-6600
Fax: (208) 375-7558
Organisation at this address: Amplify Group Llc
Matthew S. Murphy
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 237700000X
237700000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-01-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho