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Search › Idaho › 175T00000X

Andrew Micklus

NPI 1720816309 · on the registry since 2024

Practice

Address
12553 W Explorer Dr Ste 190
Boise, ID 83713
Phone
(208) 376-7083
Organisation at this address
Mentor Idaho, Llc
Thrive Community Services, Llc
Trivium Life Services Mountain West, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
28

Registry record

Primary taxonomy
175T00000X
175T00000X
Sex
Male
Record last updated
2024-07-24

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