Organization
LIFE SPRING WOMEN'S CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG Z. HALL M.D. (PRESIDENT)
(208) 523-8844
Entity
Organization
Contact information
Practice address
1660 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4360
(208) 523-8844
Mailing address
1660 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4360
(208) 523-8844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
RPA-214
ID
363L00000X
Nurse Practitioner
NP-253A
IN
Other
Enumeration date
06/07/2007
Last updated
09/13/2007
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