Organization
STEELE LAKE SPECIALTY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACKENZIE INGLE (OFFICE MANAGER)
(208) 201-0215
Entity
Organization
Contact information
Practice address
3200 CHANNING WAY STE 206, IDAHO FALLS, ID 83404-7546
(208) 529-2230
Mailing address
3200 CHANNING WAY STE 206, IDAHO FALLS, ID 83404-7546
(208) 529-2230
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
09/22/2023
Last updated
11/30/2023
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