Rurban Pllc

NPI #1205556859 in Sandpoint, Idaho

Provider Information

NPI Number: 1205556859
Entity Type: Organization
Organization Name: Rurban Pllc
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Sep 1, 2022
Last Updated: Dec 22, 2022

Practice Location

Address: 605 S OLIVE AVE
City: Sandpoint
State: Idaho
ZIP Code: 83864-1154
Phone: (208) 899-9312

Authorized Official

Name: RIO PETERSONO PETERSON, PMHNP
Title: FOUNDER/ CEO
Phone: (208) 686-8060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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