Organization
DESTIN THAYNE BEP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTIN L THAYNE (OWNER)
(208) 359-2101
Entity
Organization
Contact information
Practice address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101
(208) 356-8860
Mailing address
859 S YELLOWSTONE HWY STE 3201, REXBURG, ID 83440-6200
(208) 359-2101
(208) 356-8860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
08/12/2021
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