Organization
MADISON AVENUE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BELL (OFFICE MANAGER)
(208) 881-5351
Entity
Organization
Contact information
Practice address
1855 MADISON AVENUE, IDAHO FALLS, ID 83404
(208) 881-5351
Mailing address
1855 MADISON AVENUE, IDAHO FALLS, ID 83404
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2016
Last updated
12/29/2016
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