Organization
POCATELLO CHILDREN & ADOLESCENT CLINIC
Active
Parent organization
POCATELLO CHILDREN'S CLINIC
Other names
Pocatello Children's Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
POCATELLO CHILDREN'S CLINIC
Authorized official
JESSICA PERRY (ADMINISTRATOR)
(208) 236-9600
Entity
Organization
Contact information
Practice address
1151 HOSPITAL WAY BLDG F, POCATELLO, ID 83201-5091
(208) 232-1443
(208) 239-3434
Mailing address
1151 HOSPITAL WAY BLDG F, POCATELLO, ID 83201-5091
(208) 232-1443
(208) 239-3434
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002601400
—
ID
Enumeration date
08/13/2006
Last updated
04/22/2026
Update your record
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