Idaho Pain Center And Anesthesia Pc

NPI 1255520037 - Pain Medicine - 208VP0014X

NPI Details
NPI 1255520037
Enumeration Date 10/17/2007
Last Updated 07/18/2013
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SHANNA SHANNA
Position ACCOUNTS MANAGER
Phone (435) 755-9184
Fax (435) 755-9148
Practice Location
286 N GATEWAY DR
PROVIDENCE UT, 84332-9733, US
Phone (435) 755-9184
Fax (435) 755-9148
Business Location
286 N GATEWAY DR
STE 201
PROVIDENCE UT, 84332-5602, US
Phone (435) 755-9174
Fax
Toxanomy
Taxonomy Code 208VP0014X
License State Utah
License Number 329116-1204
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According to our database, Idaho Pain Center And Anesthesia Pc NPI is 1255520037, taxonomy code is 208VP0014X and license number is 329116-1204, license state is located at Utah. Idaho Pain Center And Anesthesia Pc physically located at 286 N Gateway Dr, Providence UT, 84332-9733. NPI Number 1033115704 has the healthcare provider type.

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1255520037 NPI number is provided on an as is basis without warranty of any kind. 1255520037 is maintained by the National Plan & Provider Enumeration System. The contents of Idaho Pain Center And Anesthesia Pc are for informational purposes only.