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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