Organization
PSYCHIATRY-ECT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREDRAG V GLIGOROVIC M.D. (OWNER)
(208) 233-8344
Entity
Organization
Contact information
Practice address
285 VISTA DR, SUITE D, POCATELLO, ID 83201
(208) 233-8344
(208) 233-6983
Mailing address
285 VISTA DR, SUITE D, POCATELLO, ID 83201
(208) 233-8344
(208) 233-6983
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M-9600
ID
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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