Organization
IPC SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI A PALUSO (ADMINISTRATOR)
(208) 748-4315
Entity
Organization
Contact information
Practice address
2841 JUNIPER DR, LEWISTON, ID 83501-4719
(208) 743-9712
(208) 298-0212
Mailing address
2841 JUNIPER DR, LEWISTON, ID 83501-4719
(208) 743-9712
(208) 298-0212
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2006
Last updated
08/22/2020
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