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1518242395
TETON OUTPATIENT, LLC
IDAHO FALLS, ID
NPI
1518242395
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Entity Type
Organization
Authorized Contact
JACOB RAYMOND BRYAN
Owner
208-419-0896
Organization Subpart ?
No
Primary Taxonomy
261QR0400X Clinic/Center, Rehabilitation
Enumeration Date
2011-10-12
Last Update Date
2011-10-12
Business Address
TETON OUTPATIENT, LLC
403 1ST ST
IDAHO FALLS, ID 83401-3928
Phone number: 208-419-0896
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Mailing Address
TETON OUTPATIENT, LLC
403 1ST ST
IDAHO FALLS, ID 83401-3928
Phone number: 208-419-0896
Copy
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