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Organization

MINI-CASSIA MISDEMEANOR

Active
Parent organization
CASSIA COUNTY
Organization subpart
Yes

Provider details

NPI number
Legal business name
CASSIA COUNTY
Authorized official
AMBER PREWITT (DIRECTOR)
(208) 878-7361
Entity
Organization

Contact information

Practice address
1359 HANSEN AVE, BURLEY, ID 83318-1821
(208) 878-7361
(208) 878-2434
Mailing address
1359 HANSEN AVE, BURLEY, ID 83318-1821
(208) 878-7361
(208) 878-2434

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
02/12/2020
Last updated
02/12/2020
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