Teton Mri of Idaho Falls
NPI #1053305144 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1053305144
- Entity Type
- Organization
- Organization Name
- Teton Mri of Idaho Falls
- Primary Specialty
- Clinic/Center - Radiology
- Enumeration Date
- Sep 6, 2005
- Last Updated
- Jul 10, 2007
Practice Location
- Address
- 2060 S WOODRUFF AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6396
- Phone
- (208) 552-0828
Authorized Official
- Name
- MS. BONNIE C. GRAY
- Title
- ADMINISTRATIVE ASSISTANT
- Phone
- (208) 552-0828
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
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