Idaho Dept of Health & Welfare Amhcalpgreg3

NPI #1104004928 in Caldwell, Idaho

Provider Information

NPI Number
1104004928
Entity Type
Organization
Organization Name
Idaho Dept of Health & Welfare Amhcalpgreg3
Primary Specialty
Psychologist - Prescribing (Medical)
Enumeration Date
Feb 4, 2008
Last Updated
Jan 28, 2009

Practice Location

Address
3402 FRANKLIN RD
State
Idaho
ZIP Code
83605-6932
Phone
(208) 459-0092

Authorized Official

Name
TODD L HURT, MS
Title
FIELD OPERATIONS MANAGER
Phone
(208) 455-7057

Specialties & Taxonomy Codes

Specialty
Psychologist - Prescribing (Medical)Prescribing (Medical)

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