Organization
AMBULATORY SURGERY CENTER OF BURLEY, LLC
Active
Parent organization
AMBULATORY SURGERY CENTER OF BURLEY, LLC
Other names
Ambulatory Surgery Center of Burley Anesthesia
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMBULATORY SURGERY CENTER OF BURLEY, LLC
Authorized official
JOSEPH R PETERSEN MD (CEO)
(208) 677-8888
Entity
Organization
Contact information
Practice address
1344 HILAND AVE STE E, BURLEY, ID 83318-1564
(208) 677-8888
(208) 678-5833
Mailing address
1344 HILAND AVE STE E, BURLEY, ID 83318-1564
(208) 677-8888
(208) 678-5833
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
07/21/2022
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