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Organization
ALTITUDE SPORT & SPINE PLLC
Active
Organization
ALTITUDE SPORT & SPINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA SIRUCEK DO (OWNER)
(208) 213-5256
Entity
Organization
Contact information
Practice address
1582 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 213-5256
Mailing address
1582 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 213-5256
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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