Mountain Health Services PC

NPI #1164539912 in Kellogg, Idaho

Provider Information

NPI Number: 1164539912
Entity Type: Organization
Organization Name: Mountain Health Services PC
Primary Specialty: Family Medicine
Enumeration Date: Aug 25, 2006
Last Updated: Feb 14, 2013

Practice Location

Address: 740 MCKINLEY AVE
City: Kellogg
State: Idaho
ZIP Code: 83837-2693
Phone: (208) 783-1267

Authorized Official

Name: FREDERICK R HALLER, M.D.
Title: MEDICAL DIRECTOR
Phone: (208) 783-1267

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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