Idaho Independent Mri LLC
NPI #1255345765 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1255345765
- Entity Type
- Organization
- Organization Name
- Idaho Independent Mri LLC
- Primary Specialty
- Clinic/Center - Radiology, Mobile
- Enumeration Date
- Jul 28, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 562 SHOUP AVE W
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-5029
- Phone
- (208) 732-1205
Authorized Official
- Name
- FREDERICK L SURBAUGH, MD
- Title
- OWNER
- Phone
- (208) 732-1205
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology, Mobile — Radiology, Mobile |
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