Tellica Imaging, LLC

NPI #1760197198 in Boise, Idaho

Provider Information

NPI Number
1760197198
Entity Type
Organization
Organization Name
Tellica Imaging, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
INTERMOUNTAIN HEALTHCARE
Primary Specialty
Clinic/Center - Radiology
Enumeration Date
Jan 19, 2023
Last Updated
Nov 20, 2023

Practice Location

Address
8505 W OVERLAND RD
City
Boise
State
Idaho
ZIP Code
83709-1644
Phone
(208) 417-5100

Authorized Official

Name
MARK L VAWDREY
Title
CFO
Phone
(801) 718-1642

Specialties & Taxonomy Codes

Specialty
Radiology - Diagnostic RadiologyDiagnostic Radiology
Clinic/Center - RadiologyRadiology

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