Individual
DR. JOHN ABRAHAM FENSTERMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2013
(208) 238-1000
(208) 238-0009
Mailing address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2013
(208) 238-1000
(208) 238-0009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MR-1113
ID
207Q00000X
Family Medicine Physician
Primary
O-0623
ID
Other
Enumeration date
06/16/2010
Last updated
11/12/2013
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