Organization
IEG ZENERGY, LLC
Active
Other names
Zenergy Sports Rehabilitation Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK AGNEW (GENERAL MANAGER)
(208) 725-5384
Entity
Organization
Contact information
Practice address
245 RAVEN RD, SUITE B, KETCHUM, ID 83340
(208) 726-7246
(208) 726-8911
Mailing address
PO BOX 1363, KETCHUM, ID 83340-1363
(208) 726-7246
(208) 726-8911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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