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Organization
SLEEP DISORDER CENTER OF EASTERN IDAHO, INC.
Active
Organization
SLEEP DISORDER CENTER OF EASTERN IDAHO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA M JACKSON POLYSOMNOGRAPHIST (OWNER)
(208) 524-8044
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF, STE 11, IDAHO FALLS, ID 83404
(208) 524-8044
(208) 525-8896
Mailing address
2001 S WOODRUFF, STE 11, IDAHO FALLS, ID 83404
(208) 524-8044
(208) 525-8896
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/18/2007
Last updated
12/18/2008
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