Idaho Street Medical Clinic
NPI #1063970143 in Homedale, Idaho
Provider Information
- NPI Number
- 1063970143
- Entity Type
- Organization
- Organization Name
- Idaho Street Medical Clinic
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Mar 7, 2019
- Last Updated
- Mar 7, 2019
Practice Location
Authorized Official
- Name
- EDITH ROE, NURSE PRACTITIONER
- Title
- PRESIDENT
- Phone
- (208) 859-4103
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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