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Organization

HUMAN DYNAMICS AND DIAGNOSTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NIKOLA ANDERSEN (OFFICE MANAGER)
(208) 524-4953
Entity
Organization

Contact information

Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 524-4953
Mailing address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 524-4953

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807961400
ID
Enumeration date
02/13/2008
Last updated
11/05/2009
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