PHS MD #1, LLC

POCATELLO, ID
NPI1124355813
Other NamePORTNEUF MEDICAL PRACTICES
Entity TypeOrganization
Authorized ContactJOHN ABREU
CFO
208-239-2110
Organization Subpart ?Yes
Primary Taxonomy261QP2300X Clinic/Center, Primary Care
Enumeration Date2009-11-17
Last Update Date2010-03-02
Business Address
PHS MD #1, LLC
651 MEMORIAL DR
POCATELLO, ID 83201-4071
Phone number: 208-239-2110
Mailing Address
PHS MD #1, LLC
PO BOX 4168
POCATELLO, ID 83205-4168
Phone number: 208-239-2110