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Organization
EAGLE ROCK MEDICAL CENTER LLC
Active
Organization
EAGLE ROCK MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDON HOWARD (CEO)
(208) 972-0420
Entity
Organization
Contact information
Practice address
919 S UTAH AVE, IDAHO FALLS, ID 83402-3322
(208) 425-6020
Mailing address
919 S UTAH AVE, IDAHO FALLS, ID 83402-3322
(208) 425-6020
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/30/2021
Last updated
03/21/2022
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