Organization
BLACKFOOT MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA TIBBITS (ADMINISTRATION)
(208) 785-2600
Entity
Organization
Contact information
Practice address
1441 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-2600
Mailing address
1441 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-2600
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
P003
ID
Other
Enumeration date
10/09/2007
Last updated
02/01/2008
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