Kootenai Tribe of Idaho
NPI #1669594057 in Bonners Ferry, Idaho
Provider Information
- NPI Number
- 1669594057
- Entity Type
- Organization
- Organization Name
- Kootenai Tribe of Idaho
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Apr 4, 2007
- Last Updated
- Oct 21, 2010
Practice Location
- Address
- 100 CIRCLE DRIVE
- City
- Bonners Ferry
- State
- Idaho
- ZIP Code
- 83805-1279
- Phone
- (208) 267-5223
Authorized Official
- Name
- KAREN K HANSON
- Title
- HEALTH CLINIC DIRECTOR
- Phone
- (208) 267-5223
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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