Organization
ROCKY MOUNTAIN DIABETES AND OSTEOPOROSIS CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET M HOOVER CPC (BILLING MANAGER)
(208) 528-9625
Entity
Organization
Contact information
Practice address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-0611
Mailing address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 523-1122
(208) 523-0611
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-841
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D-841
STATE OF IDAHO BOARD OF MEDICINE LICENSE
ID
Enumeration date
06/16/2015
Last updated
06/16/2015
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