Organization
CLINICAL RESEARCH PRIME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BAKER PHD (PRESIDENT, CHIEF RESEARCH OFFICER)
(208) 497-0600
Entity
Organization
Contact information
Practice address
187 E 13TH ST, IDAHO FALLS, ID 83404-5305
(208) 497-0600
Mailing address
187 E 13TH ST, IDAHO FALLS, ID 83404-5305
(208) 497-0600
Taxonomy
Speciality
Code
Description
License number
State
261QR1100X
Research Clinic/Center
Primary
M5835
ID
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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