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Organization
MOUNTAIN HEALTH SERVICES PC
Active
Organization
MOUNTAIN HEALTH SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK R HALLER M.D. (MEDICAL DIRECTOR)
(208) 783-1267
Entity
Organization
Contact information
Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 783-1267
(208) 786-4471
Mailing address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 783-1267
(208) 786-4471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8355
ID
Other
Enumeration date
08/25/2006
Last updated
02/14/2013
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