Mountain Health Mid Level

NPI #1700076510 in Kellogg, Idaho

Provider Information

NPI Number
1700076510
Entity Type
Organization
Organization Name
Mountain Health Mid Level
Primary Specialty
Physician Assistant - Medical
Enumeration Date
Jul 27, 2007
Last Updated
Aug 15, 2008

Practice Location

Address
740 MCKINLEY AVE
State
Idaho
ZIP Code
83837-2693
Phone
(208) 783-1267

Authorized Official

Name
MRS. LYNN HAUGHN
Title
OFFICE MANAGER
Phone
(208) 783-1267

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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