Organization
PHYSICIAN'S CHOICE CARDIOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY LATHAM MD (MANAGER)
(907) 388-5951
Entity
Organization
Contact information
Practice address
3302 VALENCIA, SUITE 201, IDAHO FALLS, ID 83404
(907) 388-5951
Mailing address
3302 VALENCIA, SUITE 201, IDAHO FALLS, ID 83404
(907) 388-5951
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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