Organization
PATRIOT HEALTHCARE, LLC
Active
Organization
PATRIOT HEALTHCARE, LLC
Active
Other names
Patriot Healthcare Family ad Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH RAY LOWTHER FNP-C (MEDICAL DIRECTOR/CEO)
(208) 541-0920
Entity
Organization
Contact information
Practice address
144 OASIS DR, POCATELLO, ID 83204-4826
(208) 541-0920
Mailing address
144 OASIS DR, POCATELLO, ID 83204-4826
(208) 541-0920
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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