Organization
HEALTH & WELLNESS CENTER OF IDAHO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC W PERTTULA M.D. (OWNER)
(208) 528-8777
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF AVE, SUITE 5, IDAHO FALLS, ID 83404-6374
(208) 528-8777
(208) 528-9777
Mailing address
2001 S WOODRUFF AVE, SUITE 5, IDAHO FALLS, ID 83404-6374
(208) 528-8777
(208) 528-9777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8241
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8069929
—
ID
Enumeration date
02/21/2007
Last updated
07/11/2016
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