Organization
INTERMOUNTAIN REGENERATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE BARRS (OFFICE MANAGER)
(919) 439-1512
Entity
Organization
Contact information
Practice address
1075 S UTAH AVE STE 200, IDAHO FALLS, ID 83402-3320
(208) 218-8622
Mailing address
1075 S UTAH AVE STE 200, IDAHO FALLS, ID 83402-3320
(208) 218-8622
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
12/07/2023
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