Organization
IDAHO STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES FLETCHER (VICE PRESIDENT FOR FINANCE/ADMIN)
(208) 282-3540
Entity
Organization
Contact information
Practice address
921 S 8TH AVE, MAIL STOP 8219, POCATELLO, ID 83209-8219
(208) 282-3540
Mailing address
921 S 8TH AVE, MAIL STOP 8219, POCATELLO, ID 83209-8219
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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