Organization
HELICASE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THADEUS KOONTZ MD (MD,PHD/OWNER)
(919) 886-0690
Entity
Organization
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(919) 886-0690
Mailing address
PO BOX 44795, BOISE, ID 83711-0795
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/10/2022
Last updated
08/09/2022
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