Prestige Ketamine PC
NPI #1588353999 in Rigby, Idaho
Provider Information
- NPI Number
- 1588353999
- Entity Type
- Organization
- Organization Name
- Prestige Ketamine PC
- Primary Specialty
- Clinic/Center - Infusion Therapy
- Enumeration Date
- May 2, 2023
- Last Updated
- May 2, 2023
Practice Location
Authorized Official
- Name
- LEVI HANSEN
- Title
- CEO
- Phone
- (208) 705-9800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Infusion Therapy — Infusion Therapy |
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