Search › Idaho › 1041C0700X
Ken Macanka
NPI 1598940520 · on the registry since 2008 · sole proprietor
Practice
- Address
- 444 W Fort St Fl 2
Boise, ID 83702 - Phone
- (208) 422-1018
- Clinicians at this address
- 58
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- CT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-05-11
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