# STEM CELL CENTERS OF IDAHO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144646126
- **Authorized official:** EMILY AUTOR (OWNER/PRESIDENT)
- **Authorized official phone:** (509) 808-0708

## Contact information

- **Practice address:** 1341 N NORTHWOOD CENTER CT STE B, COEUR D ALENE, ID 83814-2471
- **Practice address phone:** (208) 771-7054
- **Mailing address:** 223 W IRONWOOD DR, COEUR D ALENE, ID 83814-2651
- **Mailing address phone:** (208) 215-3261
- **Mailing address fax:** (208) 966-4284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2014
- **Last updated:** 06/23/2020