Fruitland Orthopedic Clinic

NPI 1710975057 - Orthopaedic Surgery - 207X00000X

NPI Details
NPI 1710975057
Enumeration Date 10/11/2005
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name JAN OLOF JAN
Position OWNER
Phone (208) 452-2510
Fax (208) 452-2513
Practice Location
1118 NW 16TH ST
SUITE C
FRUITLAND ID, 83619-2271, US
Phone (208) 452-2510
Fax (208) 452-2513
Business Location
1118 NW 16TH ST
SUITE C
FRUITLAND ID, 83619-2271, US
Phone (208) 452-2510
Fax (208) 452-2513
Toxanomy
Taxonomy Code 207X00000X
License State Oregon
License Number MD13079
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According to our database, Fruitland Orthopedic Clinic NPI is 1710975057, taxonomy code is 207X00000X and license number is MD13079, license state is located at Oregon. Fruitland Orthopedic Clinic physically located at 1118 Nw 16th St, Fruitland ID, 83619-2271. NPI Number 1033115704 has the healthcare provider type.

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1710975057 NPI number is provided on an as is basis without warranty of any kind. 1710975057 is maintained by the National Plan & Provider Enumeration System. The contents of Fruitland Orthopedic Clinic are for informational purposes only.