Eastern Idaho Foot Clinic
NPI #1225365992 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1225365992
- Entity Type
- Organization
- Organization Name
- Eastern Idaho Foot Clinic
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Nov 17, 2009
- Last Updated
- Nov 17, 2009
Practice Location
- Address
- 2565 CHANNING WAY
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7516
- Phone
- (208) 523-2928
Authorized Official
- Name
- DR. JERRY D. COOPER, D.P.M.
- Title
- OWNER
- Phone
- (208) 523-2928
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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