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Organization
CARRIAGE HOUSE OBSTETRICS AND GYNCECOLOGY, LLC
Active
Organization
CARRIAGE HOUSE OBSTETRICS AND GYNCECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATIE DAVENPORT (BILLING)
(208) 520-2636
Entity
Organization
Contact information
Practice address
1570 MIDWAY DR, SUITE 1, AMMON, ID 83406-6912
(208) 522-2557
(208) 552-2575
Mailing address
1570 MIDWAY DR, SUITE 1, AMMON, ID 83406-6912
(208) 522-2557
(208) 552-2575
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O0578
ID
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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