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Organization

BONNEVILLE SCHOOL DIST #93

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GUY J WANGSGARD (CHIEF FINANCIAL & OPERATIONS OFFICE)
(208) 557-6803
Entity
Organization

Contact information

Practice address
3549 N AMMON RD, IDAHO FALLS, ID 83401-1301
(208) 525-4400
(208) 525-4410
Mailing address
3549 N AMMON RD, IDAHO FALLS, ID 83401-1301
(208) 525-4400
(208) 525-4410

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
251300000X
Local Education Agency (LEA)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002855000
ID
Enumeration date
11/03/2005
Last updated
09/12/2025
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