IDAHO MODERN MEDICINE - PLLC

POCATELLO, ID
NPI1184255754
Entity TypeOrganization
Authorized ContactMICHAEL A ANDERSON
Physician / Owner
208-648-4789
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2020-01-31
Last Update Date2024-02-05
Business Address
IDAHO MODERN MEDICINE - PLLC
1000 POCATELLO CREEK RD STE E10
POCATELLO, ID 83201-2953
Phone number: 208-317-5371
Mailing Address
IDAHO MODERN MEDICINE - PLLC
1000 POCATELLO CREEK RD STE E10
POCATELLO, ID 83201-2953
Phone number: 208-648-4789
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