Organization
ENDOBIOGENIC INTEGRATIVE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE NICA DAVIS C.N. (ADMINISTRATOR)
(208) 478-8400
Entity
Organization
Contact information
Practice address
357 W CENTER ST STE 204, POCATELLO, ID 83204-3236
(208) 478-8400
(208) 232-6018
Mailing address
357 W CENTER ST STE 204, POCATELLO, ID 83204-3236
(208) 478-8400
(208) 232-6018
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
ID
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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