Root Cause Integrative Medicine LLC

NPI #1447718853 in Ammon, Idaho

Provider Information

NPI Number: 1447718853
Entity Type: Organization
Organization Name: Root Cause Integrative Medicine LLC
Primary Specialty: Family Medicine
Enumeration Date: Mar 5, 2019
Last Updated: Apr 10, 2019

Practice Location

Address: 1547 S MIDWAY AVE
Address 2: SUITE B
City: Ammon
State: Idaho
ZIP Code: 83406
Phone: (208) 497-0429

Authorized Official

Name: MR. JORDAN NEIL HALE, PA-C
Title: CO-OWNER/ PHYSICIAN ASSISTANT
Phone: (650) 933-6384

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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