Organization
IDAHO NEUROSURGERY & SPINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARK H ALLEN M.D. (OWNER)
(208) 552-6210
Entity
Organization
Contact information
Practice address
3345 POTOMAC WAY, IDAHO FALLS, ID 83404
(208) 552-6210
(208) 552-2027
Mailing address
3345 POTOMAC WAY, IDAHO FALLS, ID 83404
(208) 552-6210
(208) 552-2027
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
11/11/2014
Last updated
07/25/2018
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