Teton Radiology Diagnostic Llc

NPI 1013085604 - Radiology - 2085N0700X

NPI Details
NPI 1013085604
Enumeration Date 12/01/2006
Last Updated 05/14/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MICHAEL P MICHAEL
Position GENERAL MANAGER
Phone (208) 524-7237
Fax
Practice Location
2001 S WOODRUFF AVE STE 17
IDAHO FALLS ID, 83404-6372, US
Phone (208) 524-7237
Fax
Business Location
PO BOX 2147
IDAHO FALLS ID, 83403-2147, US
Phone (208) 523-4906
Fax (208) 523-2025
Toxanomy
Taxonomy Code 2085N0700X
License State
License Number
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According to our database, Teton Radiology Diagnostic Llc NPI is 1013085604, taxonomy code is 2085N0700X Teton Radiology Diagnostic Llc physically located at 2001 S Woodruff Ave Ste 17, Idaho Falls ID, 83404-6372. NPI Number 1033115704 has the healthcare provider type.

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1013085604 NPI number is provided on an as is basis without warranty of any kind. 1013085604 is maintained by the National Plan & Provider Enumeration System. The contents of Teton Radiology Diagnostic Llc are for informational purposes only.