Organization
RATHDRUM CLINIC, INC.
Active
Other names
Restored Horizons
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WHITING MD (PRESIDENT)
(208) 687-5627
Entity
Organization
Contact information
Practice address
14775 N KIMO CT, SUITE B, RATHDRUM, ID 83858-8762
(208) 687-5627
Mailing address
14775 N KIMO CT, SUITE B, RATHDRUM, ID 83858-8762
(208) 687-5627
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8126
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA0692
RAILROAD MEDICARE
ID
Enumeration date
09/25/2006
Last updated
03/18/2019
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