Sun Valley Sports Medicine, P.a.

NPI #1124061163 in Ketchum, Idaho

Provider Information

NPI Number
1124061163
Entity Type
Organization
Organization Name
Sun Valley Sports Medicine, P.a.
Primary Specialty
Orthopaedic Surgery
Enumeration Date
Jun 14, 2006
Last Updated
Jun 17, 2008

Practice Location

Address
191 5TH ST W
State
Idaho
ZIP Code
83340
Phone
(208) 726-5207

Authorized Official

Name
STEPHEN WASILWESKI, M.D.
Title
PHYSICIAN
Phone
(208) 726-5207

Specialties & Taxonomy Codes

Specialty
Orthopaedic Surgery - Sports MedicineSports Medicine
Orthopaedic Surgery

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