Luke Adam Poulter D.O.

NPI 1700290947 - Family Medicine - 207Q00000X

NPI Details
NPI 1700290947
Gender Male
Enumeration Date 06/16/2014
Last Updated 06/16/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
465 MEMORIAL DR
POCATELLO ID, 83201-4008, US
Phone (208) 282-4700
Fax (208) 282-4696
Business Location
465 MEMORIAL DR
POCATELLO ID, 83201-4008, US
Phone (208) 282-4700
Fax (208) 282-4696
Toxanomy
Taxonomy Code 207Q00000X
License State Idaho
License Number MRO-1384
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According to our database, Luke Adam Poulter D.O. NPI is 1700290947, taxonomy code is 207Q00000X and license number is MRO-1384, license state is located at Idaho. Luke Adam Poulter D.O. physically located at 465 Memorial Dr, Pocatello ID, 83201-4008. NPI Number Luke Adam Poulter D.O. has the Individual type.

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1700290947 NPI number is provided on an as is basis without warranty of any kind. 1700290947 is maintained by the National Plan & Provider Enumeration System. The contents of Luke Adam Poulter D.O. are for informational purposes only.