Snake River Ear, Nose & Throat PC

NPI #1104912740 in Twin Falls, Idaho

Provider Information

NPI Number: 1104912740
Entity Type: Organization
Organization Name: Snake River Ear, Nose & Throat PC
Primary Specialty: Specialist
Enumeration Date: Oct 4, 2006
Last Updated: Jan 15, 2013

Practice Location

Address: 706 NORTH COLLEGE ROAD
Address 2: SUITE C
City: Twin Falls
State: Idaho
ZIP Code: 83301
Phone: (208) 735-1000

Authorized Official

Name: ROD KACK, MD
Title: OWNER
Phone: (208) 735-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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