| NPI | 1114192986 |
|---|---|
| Doing Business As | PHYSICIANS & SURGEONS CLINIC OF POCATELLO |
| Entity Type | Organization |
| Authorized Contact | JACOB ERICKSON CEO 208-785-3801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2019-12-17 |