Organization
CALDWELL IMMEDIATE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN BRUCE PITTARD P.A. (OWNER/PROVIDER)
(208) 320-0258
Entity
Organization
Contact information
Practice address
2701 CARRIAGE WAY, TWIN FALLS, ID 83301-5257
(208) 320-0258
Mailing address
2701 CARRIAGE WAY, TWIN FALLS, ID 83301-5257
(208) 320-0258
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
SPHY-345
ID
Other
Enumeration date
05/13/2015
Last updated
05/26/2015
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