Grand Teton Child Neurology
NPI #1639322258 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1639322258
- Entity Type
- Organization
- Organization Name
- Grand Teton Child Neurology
- Primary Specialty
- Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology
- Enumeration Date
- Oct 28, 2008
- Last Updated
- Aug 17, 2021
Practice Location
- Address
- 2225 TETON PLZ STE B
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6494
- Phone
- (208) 529-4300
Authorized Official
- Name
- DR. PETER W CASTELLANOS, MD
- Title
- NEUROLOGIST
- Phone
- (208) 529-4300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
| Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology — Neurology with Special Qualifications in Child Neurology |
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