Organization
FALLS CENTRE FOR FUNCTIONAL MEDICINE, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY NEIL HICKS NP-C (PROVIDER)
(208) 733-4444
Entity
Organization
Contact information
Practice address
236 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 733-4444
(208) 733-4456
Mailing address
236 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 733-4444
(208) 733-4456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-180
ID
208VP0000X
Pain Medicine Physician
O-180
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730283250
—
ID
05
—
807183500
—
ID
Enumeration date
11/21/2017
Last updated
02/14/2018
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