Pearl Primary Care Pllc

NPI #1720561103 in Ammon, Idaho

Provider Information

NPI Number: 1720561103
Entity Type: Organization
Organization Name: Pearl Primary Care Pllc
Primary Specialty: Family Medicine
Enumeration Date: Sep 11, 2018
Last Updated: Sep 11, 2018

Practice Location

Address: 2705 E 17TH ST STE B
City: Ammon
State: Idaho
ZIP Code: 83406-6601
Phone: (208) 497-0566

Authorized Official

Name: MR. ZAKERY WARREN, LCPC
Title: OWNER/DIRECTOR
Phone: (208) 346-7500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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