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Organization
IDAHO STATE UNIVERSITY HEALTH CENTER
Active
Organization
IDAHO STATE UNIVERSITY HEALTH CENTER
Active
Parent organization
IDAHO STATE UNIVERSITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDAHO STATE UNIVERSITY
Authorized official
DR. RONALD M SOLBRIG MD (DIRECTOR)
(208) 282-2330
Entity
Organization
Contact information
Practice address
990 CESAR CHAVEZ AVE, POCATELLO, ID 83209-0001
(208) 282-2330
(208) 282-4036
Mailing address
921 S 8TH AVE STOP 8311, POCATELLO, ID 83209-0002
(208) 282-2330
(208) 282-4036
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/21/2006
Last updated
02/26/2015
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