Physician Skin Care

NPI 1023151156 - Family Medicine - 207Q00000X

NPI Details
NPI 1023151156
Enumeration Date 02/15/2007
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CANDACE MARIE CANDACE
Position BILLING MANAGER
Phone (208) 542-9111
Fax
Practice Location
730 S WOODRUFF AVE
IDAHO FALLS ID, 83401-5285, US
Phone (208) 542-9111
Fax
Business Location
740 S WOODRUFF AVE
IDAHO FALLS ID, 83401-5285, US
Phone (208) 542-9111
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Idaho
License Number 2082807848
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According to our database, Physician Skin Care NPI is 1023151156, taxonomy code is 207Q00000X and license number is 2082807848, license state is located at Idaho. Physician Skin Care physically located at 730 S Woodruff Ave, Idaho Falls ID, 83401-5285. NPI Number 1033115704 has the healthcare provider type.

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1023151156 NPI number is provided on an as is basis without warranty of any kind. 1023151156 is maintained by the National Plan & Provider Enumeration System. The contents of Physician Skin Care are for informational purposes only.