Organization
IDAHO VOICE AND SWALLOW CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE EDES CCC-SLP (OWNER)
(402) 318-4783
Entity
Organization
Contact information
Practice address
875 S VANGUARD WAY STE 200, MERIDIAN, ID 83642-8542
(208) 298-9949
(208) 274-4474
Mailing address
875 S VANGUARD WAY STE 200, MERIDIAN, ID 83642-8542
(208) 298-9949
(208) 274-4474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/29/2024
Last updated
05/23/2024
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