Idaho Falls Clinic, P.a.

NPI #1811932411 in Idaho Falls, Idaho

Provider Information

NPI Number: 1811932411
Entity Type: Organization
Organization Name: Idaho Falls Clinic, P.a.
Primary Specialty: Clinic/Center
Enumeration Date: Jun 18, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 2001 S WOODRUFF AVE
Address 2: SUITE #15
City: Idaho Falls
State: Idaho
ZIP Code: 83404-6374
Phone: (208) 522-7310

Authorized Official

Name: MS. CHRISTINE C. CLARK
Title: ADMINISTRATOR
Phone: (208) 522-7310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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