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Individual

HOLLY ZOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2060 S WOODRUFF AVE, IDAHO FALLS, ID 83404-6396
(208) 523-7246
(208) 523-7247
Mailing address
PO BOX 2404, IDAHO FALLS, ID 83403-2404
(208) 523-7246
(208) 523-9224

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
4301088935
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
M-9902
ID
207LP2900X
Pain Medicine (Anesthesiology) Physician
PENDING
WI
208VP0014X
Interventional Pain Medicine Physician
Primary
SPHY-9902
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00472474
RAILROAD MEDICARE
Enumeration date
08/17/2006
Last updated
05/06/2014
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