Payette Lakes Medical Clinic, PA

NPI #1255462263 in Mccall, Idaho

Provider Information

NPI Number
1255462263
Entity Type
Organization
Organization Name
Payette Lakes Medical Clinic, PA
Primary Specialty
Clinic/Center - Primary Care
Enumeration Date
Mar 8, 2007
Last Updated
Mar 11, 2008

Practice Location

Address
211 FOREST STREET
City
Mccall
State
Idaho
ZIP Code
83638
Phone
(208) 634-2225

Authorized Official

Name
JACQUELINE R. BRUNS
Title
VP - PHYSICIAN SERVICES
Phone
(208) 634-4061

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care

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