Southfork Healthcare
NPI #1134462856 in Swan Valley, Idaho
Provider Information
- NPI Number
- 1134462856
- Entity Type
- Organization
- Organization Name
- Southfork Healthcare
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Apr 1, 2013
- Last Updated
- May 29, 2023
Practice Location
- Address
- 166 ELK PATH
- City
- Swan Valley
- State
- Idaho
- ZIP Code
- 83449-0101
- Phone
- (208) 360-1997
Authorized Official
- Name
- WENDY SWOPE, NP
- Title
- ADMINISTRATOR
- Phone
- (208) 360-1997
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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