Organization
THE PEDIATRIC PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABRAM COLLARD DO (PEDIATRICIAN)
(208) 701-0277
Entity
Organization
Contact information
Practice address
1236 BOND AVE STE B, REXBURG, ID 83440-3503
(208) 701-0277
(208) 701-0294
Mailing address
1236 BOND AVE STE B, REXBURG, ID 83440-3503
(208) 701-0277
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801350590
—
ID
Enumeration date
01/26/2019
Last updated
11/08/2021
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