Organization
SOUTHEASTERN DISTRICT HEALTH DEPT.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRICIA NANNETTE CODDING (FACHS DIRECTOR)
(208) 233-9080
Entity
Organization
Contact information
Practice address
1901 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
(208) 233-9080
(208) 234-7169
Mailing address
1901 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
(208) 233-9080
(208) 234-7169
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
04/15/2008
Last updated
10/28/2008
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