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Individual

CHRISTOPHER LEIF EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2330 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 542-7060
Mailing address
810 N 650 E # 8, BASALT, ID 83218-7706
(208) 243-4520

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
78244
ID

Other

Enumeration date
12/18/2023
Last updated
12/18/2023
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