Organization
RSM PA PLLC
Active
Organization
RSM PA PLLC
Active
Other names
Family First Health Centers South
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER SCOTT MALM PA (OWNER)
(208) 238-0400
Entity
Organization
Contact information
Practice address
1595 BANNOCK HWY, POCATELLO, ID 83204
(208) 238-0400
(208) 238-0401
Mailing address
1595 BANNOCK HWY, POCATELLO, ID 83204
(208) 238-0400
(208) 238-0401
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA220
ID
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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