Individual
RAYMOND DALE PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA-1651
ID
Other
Enumeration date
10/10/2018
Last updated
04/08/2021
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