Organization
TETON NUCLEAR MEDICINE SERVICE LLC
Active
Organization
TETON NUCLEAR MEDICINE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANNY L DAVIS (MANAGER)
(208) 525-3201
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF AVE, STE 20, IDAHO FALLS, ID 83404-6374
(208) 525-3201
Mailing address
2001 S WOODRUFF AVE, STE 20, IDAHO FALLS, ID 83404-6374
(208) 525-3201
Taxonomy
Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
—
—
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
—
—
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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