Organization
INTERMOUNTAIN MEDICAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE BALDWIN (EXECUTIVE DIRECTOR)
(208) 384-3060
Entity
Organization
Contact information
Practice address
323 E RIVERSIDE DR, SUITE 108, EAGLE, ID 83616-6864
(208) 367-7510
Mailing address
877 W MAIN ST STE 603, BOISE, ID 83702-6070
(208) 954-8175
(208) 384-9023
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
07/17/2007
Last updated
10/31/2023
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