Organization
EAST IDAHO SURGICAL ASSISTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA MOLBERT CSFA (OWNER)
(214) 227-2457
Entity
Organization
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
1435 SCORPIUS DR, IDAHO FALLS, ID 83402-1805
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
151909
ID
Other
Enumeration date
12/04/2015
Last updated
01/28/2016
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