Organization
TREASURE VALLEY SERVICE COORDINATION
Active
Parent organization
TREASURE VALLEY PEDIATRICS
Organization subpart
Yes
Provider details
NPI number
Legal business name
TREASURE VALLEY PEDIATRICS
Authorized official
MRS. KATIE APPLE (OFFICE MANAGER)
(208) 884-1030
Entity
Organization
Contact information
Practice address
1620 S CELEBRATION AVE, MERIDIAN, ID 83642-2779
(208) 884-1030
(208) 884-3058
Mailing address
1620 S CELEBRATION AVE, MERIDIAN, ID 83642-2779
(208) 884-1030
(208) 884-3058
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807016700
—
ID
Enumeration date
08/27/2010
Last updated
08/27/2010
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