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1437615952
POCATELLO WELLNESS CLINIC, LLC
POCATELLO, ID
NPI
1437615952
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Entity Type
Organization
Authorized Contact
DUSTIN RENO
Owner
208-637-9610
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2019-02-20
Last Update Date
2024-04-23
Business Address
POCATELLO WELLNESS CLINIC, LLC
1155 YELLOWSTONE AVE STE D
POCATELLO, ID 83201-4369
Phone number: 208-637-9610
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Mailing Address
POCATELLO WELLNESS CLINIC, LLC
1155 YELLOWSTONE AVE STE D
POCATELLO, ID 83201-4369
Phone number: 208-637-9610
Copy
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