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Organization

JOSEPH LEON MARTINDALE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH LEON MARTINDALE (OWNER)
(208) 237-3612
Entity
Organization

Contact information

Practice address
4460 CENTRAL WAY, STE 3, CHUBBUCK, ID 83202-5095
(208) 237-3612
(208) 237-5192
Mailing address
4460 CENTRAL WAY, STE 3, CHUBBUCK, ID 83202-5095
(208) 237-3612
(208) 237-5192

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
O-0391
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1538262589
ID
Enumeration date
01/17/2008
Last updated
01/17/2008
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