Organization
RADIAL FIRST HOLDINGS
Active
Other names
Radial First Heart Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E LASSETTER MD (OWNER/PROVIDER)
(208) 523-3050
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF AVE STE 20, IDAHO FALLS, ID 83404-6373
(208) 523-3050
Mailing address
PO BOX 2386, IDAHO FALLS, ID 83403-2386
(208) 523-3050
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M11673
IDAHO LICENSE
ID
Enumeration date
01/02/2019
Last updated
04/28/2021
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