Organization
HUMAN DYNAMICS AND DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLA ANDERSEN (OFFICE MANAGER)
20852444953
Entity
Organization
Contact information
Practice address
803 MONROE ST STE 2, SALMON, ID 83467-5036
(208) 524-4953
(208) 524-7335
Mailing address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 524-4953
(208) 524-7335
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807347100
—
ID
Enumeration date
05/11/2007
Last updated
07/10/2013
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