Organization
GENERATIONS WOMEN'S CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY LOVELL MD (MANAGING MEMBER)
(208) 656-8864
Entity
Organization
Contact information
Practice address
36 PROFESSIONAL PLZ, REXBURG, ID 83440-2049
(208) 656-8864
(208) 656-8877
Mailing address
36 PROFESSIONAL PLZ, REXBURG, ID 83440-2049
(208) 656-8864
(208) 656-8877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
10/06/2008
Last updated
10/07/2008
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