Organization
GEM STATE ENDOSCOPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE BLEVINS (ADMINISTRATOR)
(208) 298-2135
Entity
Organization
Contact information
Practice address
3709 14TH STREET, LEWISTON, ID 83501
(208) 743-4373
(208) 743-3369
Mailing address
2517 17TH ST STE B, LEWISTON, ID 83501-6311
(208) 743-4373
(208) 743-3369
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2016
Last updated
08/09/2016
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