Mountain States Diabetes Relief, LLC
NPI #1144783499 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1144783499
- Entity Type
- Organization
- Organization Name
- Mountain States Diabetes Relief, LLC
- Primary Specialty
- Internal Medicine - Endocrinology, Diabetes & Metabolism
- Enumeration Date
- Apr 12, 2019
- Last Updated
- Apr 12, 2019
Practice Location
- Address
- 4573 E MAJESTIC
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83406
- Phone
- (208) 520-2636
Authorized Official
- Name
- KATIE DAVENPORT
- Title
- PARTNER
- Phone
- (208) 520-2636
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Endocrinology, Diabetes & Metabolism — Endocrinology, Diabetes & Metabolism |
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