Organization
INTERMOUNTAIN NEURODIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOTTIE M LAFLIN R.EEG/T, CNIM (PRESIDENT)
(208) 528-7566
Entity
Organization
Contact information
Practice address
4596 MCCOWIN LN, IDAHO FALLS, ID 83406-8350
(208) 524-8372
Mailing address
4596 MCCOWIN LANE, IDAHO FALLS, ID 83403
(208) 524-8372
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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