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1295754265
SOUTHEAST IDAHO GASTROENTEROLOGY,PLLC
POCATELLO, ID
NPI
1295754265
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Entity Type
Organization
Authorized Contact
DARRYL BRUCE COOK
Member
208-232-6616
Organization Subpart ?
No
Primary Taxonomy
207RG0100X Internal Medicine Gastroenterology
Enumeration Date
2006-07-19
Last Update Date
2012-09-25
Business Address
SOUTHEAST IDAHO GASTROENTEROLOGY,PLLC
1151 HOSPITAL WAY BLDG A
POCATELLO, ID 83201-2763
Phone number: 208-232-6616
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Mailing Address
SOUTHEAST IDAHO GASTROENTEROLOGY,PLLC
PO BOX 4788
POCATELLO, ID 83205-4788
Phone number: 208-232-6616
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