Organization
PCS PROCEDURE SUITE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L MANSFIELD MD (OWNER)
(208) 234-2300
Entity
Organization
Contact information
Practice address
110 VISTA DR, POCATELLO, ID 83201-5824
(208) 234-2300
(208) 234-0026
Mailing address
110 VISTA DR, POCATELLO, ID 83201-5824
(208) 234-2300
(208) 234-0026
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2022
Last updated
09/28/2023
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