Patriot Healthcare, LLC

NPI #1376083568 in Pocatello, Idaho

Provider Information

NPI Number: 1376083568
Entity Type: Organization
Organization Name: Patriot Healthcare, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Mar 7, 2017
Last Updated: Mar 7, 2017

Practice Location

Address: 144 OASIS DR
City: Pocatello
State: Idaho
ZIP Code: 83204-4826
Phone: (208) 541-0920

Authorized Official

Name: MR. KENNETH RAY LOWTHER, FNP-C
Title: MEDICAL DIRECTOR/CEO
Phone: (208) 541-0920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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