Organization
ROTH FAMILY MEDICINE AND MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE ABRAHAM ROTH FNP (OWNER OPERATOR)
(510) 502-9455
Entity
Organization
Contact information
Practice address
2890 RIDGEVIEW LN, POCATELLO, ID 83204-7291
(510) 502-9455
Mailing address
2890 RIDGEVIEW LN, POCATELLO, ID 83204-7291
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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