Grand Teton Surgical Center LLC
NPI #1841295227 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1841295227
- Entity Type
- Organization
- Organization Name
- Grand Teton Surgical Center LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Jun 14, 2005
- Last Updated
- Mar 2, 2010
Practice Location
- Address
- 2290 CORONADO ST
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7552
- Phone
- (208) 524-3800
Authorized Official
- Name
- TERESA WELLARD, R.N.
- Title
- DIRECTOR OF NURSING
- Phone
- (208) 524-3800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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