Individual
SPENCER GARRETT SEIBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
502 TYHEE AVE, AMERICAN FALLS, ID 83211-1224
(208) 226-3200
Mailing address
510 ROOSEVELT ST, AMERICAN FALLS, ID 83211-1362
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-0803
ID
Other
Enumeration date
07/03/2011
Last updated
04/26/2019
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