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Organization
IEG ZENERGY, LLC
Active
Organization
IEG ZENERGY, LLC
Active
Other names
Zenergy Sports Rehabilitation Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK AGNEW (GENERAL MANAGER)
(208) 725-5384
Entity
Organization
Contact information
Practice address
245 RAVEN RD, SUITE B, KETCHUM, ID 83340
(208) 726-7246
(208) 726-8911
Mailing address
PO BOX 1363, KETCHUM, ID 83340-1363
(208) 726-7246
(208) 726-8911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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