Organization
IDAHO PROSTHETICS & ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE WRIGHT (OFFICE MANAGER)
(208) 478-8800
Entity
Organization
Contact information
Practice address
333 N 18TH AVE STE B4, POCATELLO, ID 83201-3322
(208) 478-8000
(208) 478-8801
Mailing address
333 N 18TH AVE STE B4, POCATELLO, ID 83201-3322
(208) 478-8000
(208) 478-8801
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805166100
—
ID
Enumeration date
03/12/2007
Last updated
03/03/2020
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