Organization
MOUNTAIN FALLS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAULEEN MARIE STRADLING (OWNER)
(208) 403-2107
Entity
Organization
Contact information
Practice address
1995 E 17TH ST, IDAHO FALLS, ID 83404-6493
(208) 403-2107
Mailing address
1034 E 800 N, SHELLEY, ID 83274-5304
(208) 403-2107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/24/2014
Last updated
03/24/2014
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