Portneuf Asc, LLC
NPI #1871016071 in Pocatello, Idaho
Provider Information
- NPI Number
- 1871016071
- Entity Type
- Organization
- Organization Name
- Portneuf Asc, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- POCATELLO HEALTH SYSTEM, LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Jul 19, 2017
- Last Updated
- Jul 19, 2017
Practice Location
Authorized Official
- Name
- STEPHEN C PETROVICH
- Title
- EVP
- Phone
- (615) 296-3000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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