Snake River Pediatrics, PC

NPI #1720489396 in Fruitland, Idaho

Provider Information

NPI Number: 1720489396
Entity Type: Organization
Organization Name: Snake River Pediatrics, PC
Primary Specialty: Clinic/Center - Rural Health
Enumeration Date: Sep 14, 2014
Last Updated: Aug 16, 2023

Practice Location

Address: 1100 NW 12TH ST
City: Fruitland
State: Idaho
ZIP Code: 83619-5040
Phone: (208) 452-6556

Authorized Official

Name: MATTHEW JOSEPH BERRIA, PHD, PA-C
Title: PRESIDENT
Phone: (208) 740-4518

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Rural Health — Rural Health	261QR1300X	Primary

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