| NPI | 1205025673 |
|---|---|
| Doing Business As | PHYSICIANS AND SURGEONS CLINIC OF POCATELLO |
| Entity Type | Organization |
| Authorized Contact | JACOB ERICKSON CEO 208-785-3801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2019-12-16 |