Teton Spine, Pllc

NPI 1225432313 - Neurological Surgery - 207T00000X

NPI Details
NPI 1225432313
Enumeration Date 10/17/2014
Last Updated 10/17/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JONATHAN T JONATHAN
Position OWNER
Phone (208) 239-2260
Fax
Practice Location
777 HOSPITAL WAY
SUITE 115
POCATELLO ID, 83201-5175, US
Phone (208) 239-2260
Fax
Business Location
PO BOX 4836
POCATELLO ID, 83205-4836, US
Phone (516) 424-5892
Fax
Toxanomy
Taxonomy Code 207T00000X
License State
License Number
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According to our database, Teton Spine, Pllc NPI is 1225432313, taxonomy code is 207T00000X Teton Spine, Pllc physically located at 777 Hospital Way, Pocatello ID, 83201-5175. NPI Number 1033115704 has the healthcare provider type.

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1225432313 NPI number is provided on an as is basis without warranty of any kind. 1225432313 is maintained by the National Plan & Provider Enumeration System. The contents of Teton Spine, Pllc are for informational purposes only.