Carriage House Obstetrics and Gyncecology, LLC

NPI #1619270139 in Ammon, Idaho

Provider Information

NPI Number: 1619270139
Entity Type: Organization
Organization Name: Carriage House Obstetrics and Gyncecology, LLC
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Dec 7, 2010
Last Updated: Dec 7, 2010

Practice Location

Address: 1570 MIDWAY DR
Address 2: SUITE 1
City: Ammon
State: Idaho
ZIP Code: 83406-6912
Phone: (208) 522-2557

Authorized Official

Name: MRS. KATIE DAVENPORT
Title: BILLING
Phone: (208) 520-2636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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