Organization
HUMAN DYNAMICS AND DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLA ANDERSEN (OFFICE MANAGER)
(208) 524-4953
Entity
Organization
Contact information
Practice address
2043 E CENTER ST STE 211, POCATELLO, ID 83201-3300
(208) 524-4953
(208) 524-7335
Mailing address
2043 E CENTER ST STE 211, POCATELLO, ID 83201-3300
(208) 524-4953
(208) 524-7335
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807961402
—
ID
Enumeration date
02/06/2008
Last updated
11/05/2009
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