| NPI | 1053481218 |
|---|---|
| Other Name | IDAHO FALLS SURGICAL CENTER ASC |
| Entity Type | Organization |
| Authorized Contact | MARK L PETERSEN President 208-529-1945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: ID 13-C0001000) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-06-09 |