Endobiogenic Integrative Medical Center

NPI #1821239781 in Pocatello, Idaho

Provider Information

NPI Number: 1821239781
Entity Type: Organization
Organization Name: Endobiogenic Integrative Medical Center
Primary Specialty: Nutritionist
Enumeration Date: Mar 23, 2009
Last Updated: Mar 23, 2009

Practice Location

Address: 357 W CENTER ST STE 204
City: Pocatello
State: Idaho
ZIP Code: 83204-3236
Phone: (208) 478-8400

Authorized Official

Name: MRS. ANNETTE NICA DAVIS, C.N.
Title: ADMINISTRATOR
Phone: (208) 478-8400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist	133N00000X	Primary

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