Organization
ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS VANCE DAVIS D.O. (MEMBER)
(208) 232-6616
Entity
Organization
Contact information
Practice address
1151 HOSPITAL WAY BLDG A, POCATELLO, ID 83201-2763
(208) 232-6616
(208) 232-6618
Mailing address
PO BOX 4788, POCATELLO, ID 83205-4788
(208) 232-6616
(208) 232-6618
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2006
Last updated
08/22/2020
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