Organization
MOUNTAIN VALLEY ORTHOPEDICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN GERALD MCMANUS M.D. (PRESIDENT)
(208) 839-2299
Entity
Organization
Contact information
Practice address
HC 1 BOX 85 M, WHITE BIRD, ID 83554-9703
(208) 839-2299
(208) 839-2858
Mailing address
HC 1 BOX 85 M, WHITE BIRD, ID 83554-9703
(208) 839-2299
(208) 839-2858
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-5614
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710063698
PERSONAL NPI
ID
Enumeration date
11/01/2006
Last updated
08/22/2020
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