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Organization
ROOT CAUSE INTEGRATIVE MEDICINE LLC
Active
Organization
ROOT CAUSE INTEGRATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORDAN NEIL HALE PA-C (CO-OWNER/ PHYSICIAN ASSISTANT)
(650) 933-6384
Entity
Organization
Contact information
Practice address
1547 S MIDWAY AVE, SUITE B, AMMON, ID 83406
(208) 497-0429
(208) 497-0430
Mailing address
1547 S MIDWAY AVE, SUITE B, AMMON, ID 83406
(208) 497-0429
(208) 497-0430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
04/10/2019
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