Altitude Sport & Spine Pllc
NPI #1992663595 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1992663595
- Entity Type
- Organization
- Organization Name
- Altitude Sport & Spine Pllc
- Primary Specialty
- Family Medicine - Sports Medicine
- Enumeration Date
- Jan 13, 2026
- Last Updated
- Jan 13, 2026
Practice Location
- Address
- 1582 ELK CREEK DR
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-8322
- Phone
- (208) 213-5256
Authorized Official
- Name
- JOSHUA SIRUCEK, DO
- Title
- OWNER
- Phone
- (208) 213-5256
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Sports Medicine — Sports Medicine |
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