Idaho Street Medical Clinic
NPI #1023639622 in Homedale, Idaho
Provider Information
- NPI Number
- 1023639622
- Entity Type
- Organization
- Organization Name
- Idaho Street Medical Clinic
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- May 5, 2020
- Last Updated
- May 5, 2020
Practice Location
Authorized Official
- Name
- EDITH MARY ROE, NP-BC
- Title
- NURSE PRACTITIONER
- Phone
- (208) 859-4103
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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