GRAND TETON GASTROENTEROLOGY
Organization (NPI-2)
Active
Nurse Practitioner
Provider Information
- NPI Number
1457520900- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 2770 CORTEZ AVE, IDAHO FALLS, ID, 834047590
- Phone
- (208) 522-4000
- Fax
- (208) 528-4242
Specialties & Taxonomies
Nurse Practitioner
Primary License: ID