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Organization

FORTIFY OPTIMAL HEALTH

Active
Other names
FORTIFY OPTIMAL HEALTH
Organization subpart
No

Provider details

NPI number
Authorized official
SUSANNAH HANCOCK FNP (CEO)
(619) 602-4520
Entity
Organization

Contact information

Practice address
1189 RED ROBIN AVE, AMMON, ID 83401-5747
(619) 602-4520
Mailing address
784 SOUTH CLEAR LOOP STE R, POST FALLS, ID 83854
(619) 602-4520

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
04/17/2025
Last updated
04/17/2025
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