Organization
AURORA MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS WILLIAMS (OWNER)
(208) 251-9985
Entity
Organization
Contact information
Practice address
348 W CLARK ST, POCATELLO, ID 83204-3148
(208) 242-3376
(208) 242-3245
Mailing address
348 W CLARK ST, POCATELLO, ID 83204-3148
(208) 242-3376
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
04/02/2020
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