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Organization
POCATELLO ORTHOPAEDICS AND SPORTS MEDICINE INSTITUTE PA
Active
Organization
POCATELLO ORTHOPAEDICS AND SPORTS MEDICINE INSTITUTE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA J SMITH (OFFICE MANAGER)
(208) 233-2100
Entity
Organization
Contact information
Practice address
333 N 18TH AVE, SUITE D-1, POCATELLO, ID 83201-3358
(208) 233-2100
(208) 233-3146
Mailing address
333 N 18TH AVE, SUITE D-1, POCATELLO, ID 83201-3358
(208) 233-2100
(208) 233-3146
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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