Organization
EAST IDAHO WOUND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN KYLER CROFT FNP-C (NP)
(208) 541-8879
Entity
Organization
Contact information
Practice address
1005 TERRY DR, IDAHO FALLS, ID 83404-5122
(208) 541-8879
Mailing address
1005 TERRY DR, IDAHO FALLS, ID 83404-5122
(208) 541-8879
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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