Organization
RIVERSIDE ORTHOPEDIC CLINIC
Active
Organization
RIVERSIDE ORTHOPEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WHITE (OFFICE MANAGER)
(208) 452-3111
Entity
Organization
Contact information
Practice address
910 NW 16TH ST, #205, FRUITLAND, ID 83619-2265
(208) 452-3111
(208) 452-3666
Mailing address
910 NW 16TH ST, #205, FRUITLAND, ID 83619-2265
(208) 452-3111
(208) 452-3666
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-10556
ID
207X00000X
Orthopaedic Surgery Physician
M-10864
ID
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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