EASTERN IDAHO SPINE CENTER

IDAHO FALLS, ID
NPI1154593705
Entity TypeOrganization
Authorized ContactSHANE CHRISTIAN MANGRUM
Owner
208-535-4343
Organization Subpart ?No
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2008-03-24
Last Update Date2008-06-06
Business Address
EASTERN IDAHO SPINE CENTER
2860 CHANNING WAY STE 112
IDAHO FALLS, ID 83404-7531
Phone number: 208-535-4343
Mailing Address
EASTERN IDAHO SPINE CENTER
2860 CHANNING WAY STE 112
IDAHO FALLS, ID 83404-7531
Phone number: 208-535-4343
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