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Organization
SNAKE RIVER EAR, NOSE & THROAT PC
Active
Organization
SNAKE RIVER EAR, NOSE & THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROD KACK MD (OWNER)
(208) 735-1000
Entity
Organization
Contact information
Practice address
706 NORTH COLLEGE ROAD, SUITE C, TWIN FALLS, ID 83301
(208) 735-1000
(208) 732-5345
Mailing address
706 NORTH COLLEGE ROAD, SUITE C, TWIN FALLS, ID 83301
(208) 735-1000
(208) 732-5345
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A89785
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805168100
—
ID
Enumeration date
10/04/2006
Last updated
01/15/2013
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