Organization
CLOVER CREEK MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY STRONG NURSE PRACTITIONER (CEO)
(801) 362-0157
Entity
Organization
Contact information
Practice address
175 NORTH MAIN STREET, BLOOMINGTON, ID 83223-8322
(801) 362-0157
(801) 362-0157
Mailing address
PO BOX 208, BLOOMINGTON, ID 83223-0208
(801) 362-0157
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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