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Organization

TARGHEE INTERNAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LIISA OSWALD (SECRETARY- TREASURER)
(208) 356-7755
Entity
Organization

Contact information

Practice address
232 E 1ST N, REXBURG, ID 83440-1616
(208) 356-7755
Mailing address
PO BOX 275, REXBURG, ID 83440-0275
(208) 356-7755

Taxonomy

Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
O-305
ID

Other

Enumeration date
05/02/2007
Last updated
08/22/2020
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