GREENWALD NEUROSURGICAL

IDAHO FALLS, ID
NPI1124198403
Entity TypeOrganization
Authorized ContactJANEENE A DITMORE
Office Manager
208-535-4800
Organization Subpart ?No
Primary Taxonomy174400000X Specialist
(Licence: ID  M-6947)
Enumeration Date2006-11-08
Last Update Date2009-07-13
Business Address
GREENWALD NEUROSURGICAL
3155 CHANNING WAY SUITE B
IDAHO FALLS, ID 83404-7546
Phone number: 208-535-4800
Mailing Address
GREENWALD NEUROSURGICAL
3155 CHANNING WAY SUITE B
IDAHO FALLS, ID 83404-7546
Phone number: 208-535-4800
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