Sunrise Ketamine Clinic LLC
NPI #1205598398 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1205598398
- Entity Type
- Organization
- Organization Name
- Sunrise Ketamine Clinic LLC
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Enumeration Date
- Oct 6, 2021
- Last Updated
- Oct 6, 2021
Practice Location
- Address
- 3555 POTOMAC WAY STE B
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-4985
- Phone
- (208) 524-9080
Authorized Official
- Name
- BRYAN TODD MERKLEY, CRNA
- Title
- OWNER
- Phone
- (208) 520-0527
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Anesthetist, Certified Registered |
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