# FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962916304
- **Authorized official:** GEOFFREY NEIL HICKS NP-C (PROVIDER)
- **Authorized official phone:** (208) 733-4444

## Contact information

- **Practice address:** 236 MARTIN ST, TWIN FALLS, ID 83301-4542
- **Practice address phone:** (208) 733-4444
- **Practice address fax:** (208) 733-4456
- **Mailing address:** 236 MARTIN ST, TWIN FALLS, ID 83301-4542
- **Mailing address phone:** (208) 733-4444
- **Mailing address fax:** (208) 733-4456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | O-180 | ID | Yes |
| 208VP0000X | Pain Medicine Physician | O-180 | ID | — |

## Other

- **Enumeration date:** 11/21/2017
- **Last updated:** 02/14/2018