Organization
COMMUNITY CARE, PLLC
Active
Other names
Community Care
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY RUSSELL (ADMINISTRATOR)
(208) 525-8448
Entity
Organization
Contact information
Practice address
2725 CHANNING WAY, IDAHO FALLS, ID 83404
(208) 525-8448
(208) 525-8118
Mailing address
2725 CHANNING WAY, IDAHO FALLS, ID 83404
(208) 525-8448
(208) 525-8118
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-819
ID
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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