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Organization

CENTER STREET HEALTH CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CYNTHIA MARIE RICE RNCNP (OWNER/PROVIDER)
(208) 233-9355
Entity
Organization

Contact information

Practice address
1553 E CENTER ST, POCATELLO, ID 83201-4135
(208) 233-9355
(208) 233-9300
Mailing address
1553 E CENTER ST, POCATELLO, ID 83201-4135
(208) 233-9355
(208) 233-9300

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP252A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004383300
ID
Enumeration date
08/20/2008
Last updated
09/30/2008
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