Organization
EAST IDAHO CENTER FOR SLEEP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DODIE R NOLES (MEMBER)
(541) 646-0858
Entity
Organization
Contact information
Practice address
1341 EAST 17TH STREET, IDAHO FALLS, ID 83404
(208) 523-7246
Mailing address
302 E HERSEY ST STE 12, ASHLAND, OR 97520-1957
(541) 646-0858
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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