Organization
MOUNTAIN FALLS QUICK CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH LOWTHER FNP-C (CLINICAL DIRECTOR)
(208) 541-0920
Entity
Organization
Contact information
Practice address
1995 E 17TH ST #1, IDAHO FALLS, ID 83404
(208) 357-9193
(208) 357-9173
Mailing address
1995 E 17TH ST #1, IDAHO FALLS, ID 83404
(208) 357-9193
(208) 357-9173
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
363LF0000X
ID
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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