Individual
KATRINA E SPANGENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-4700
Mailing address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13821094-1205
UT
207Q00000X
Family Medicine Physician
Primary
MRM-2045
ID
Other
Enumeration date
05/21/2021
Last updated
10/29/2024
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