Organization
FAMILY PRACTICE GROUP, P.A.
Active
Other names
InterMountain Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY STRANSKI (ADMINISTRATOR)
(208) 238-1000
Entity
Organization
Contact information
Practice address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2073
(208) 238-1000
(238) 238-0009
Mailing address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2073
(208) 238-1000
(238) 238-0009
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/09/2006
Last updated
11/26/2024
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