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Organization
FAMILY PRACTICE GROUP, P.A.
Active
Organization
FAMILY PRACTICE GROUP, P.A.
Active
Other names
InterMountain Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY STRANSKI (ADMINISTRATOR)
(208) 238-1000
Entity
Organization
Contact information
Practice address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2073
(208) 238-1000
(238) 238-0009
Mailing address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2073
(208) 238-1000
(238) 238-0009
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QR0404X
Cardiac Rehabilitation Clinic/Center
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/09/2006
Last updated
08/11/2026
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