Organization
MATERNAL FETAL SERVICES OF UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF RYDBURG (VP)
(615) 373-7415
Entity
Organization
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
(208) 529-7021
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
(208) 529-7021
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
11/05/2007
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