# POCATELLO ORTHOPAEDICS AND SPORTS MEDICINE INSTITUTE PA

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

## Provider details

- **NPI number:** 1265683445
- **Authorized official:** REBECCA J SMITH (OFFICE MANAGER)
- **Authorized official phone:** (208) 233-2100

## Contact information

- **Practice address:** 333 N 18TH AVE, SUITE D-1, POCATELLO, ID 83201-3358
- **Practice address phone:** (208) 233-2100
- **Practice address fax:** (208) 233-3146
- **Mailing address:** 333 N 18TH AVE, SUITE D-1, POCATELLO, ID 83201-3358
- **Mailing address phone:** (208) 233-2100
- **Mailing address fax:** (208) 233-3146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 10/06/2008
- **Last updated:** 10/06/2008