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Organization

IDAHO FOOT SURGERY CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRUCE G TOLMAN DPM (OWNER)
(208) 529-8393
Entity
Organization

Contact information

Practice address
1540 ELK CREEK DR., IDAHO FALLS, ID 83404
(208) 529-8393
Mailing address
1540 ELK CREEK DR., IDAHO FALLS, ID 83404
(208) 529-8393

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1870101
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002512000
ID
Enumeration date
08/15/2006
Last updated
06/19/2008
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