Organization
NUBACK INSTITUTE OF NORTH IDAHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC J BACKMAN (OWNER)
(208) 635-5219
Entity
Organization
Contact information
Practice address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 635-5219
Mailing address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 635-5219
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/09/2021
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