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Organization
LEWISTON ORTHOPAEDIC ASSOCIATES PA
Active
Organization
LEWISTON ORTHOPAEDIC ASSOCIATES PA
Active
Other names
Lewiston Orthopaedic Associates PA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY L KEENE (CEO)
(208) 298-1020
Entity
Organization
Contact information
Practice address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Mailing address
320 WARNER DR, LEWISTON, ID 83501-4441
(208) 743-3523
(208) 746-8741
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
BL04-213478
ID
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010026897
REGENCE BLUESHIELD IDAHO
ID
05
—
002397200
—
ID
05
—
7849003
—
WA
01
—
89409
BCI
ID
Enumeration date
12/04/2006
Last updated
01/24/2017
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