Organization
CARRIAGE HOUSE OBSTETRICS AND GYNCECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATIE DAVENPORT (BILLING)
(208) 520-2636
Entity
Organization
Contact information
Practice address
1570 MIDWAY DR, SUITE 1, AMMON, ID 83406-6912
(208) 522-2557
(208) 552-2575
Mailing address
1570 MIDWAY DR, SUITE 1, AMMON, ID 83406-6912
(208) 522-2557
(208) 552-2575
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
O0578
ID
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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