TETON OUTPATIENT, LLC

IDAHO FALLS, ID
NPI1518242395
Entity TypeOrganization
Authorized ContactJACOB RAYMOND BRYAN
Owner
208-419-0896
Organization Subpart ?No
Primary Taxonomy261QR0400X Clinic/Center, Rehabilitation
Enumeration Date2011-10-12
Last Update Date2011-10-12
Business Address
TETON OUTPATIENT, LLC
403 1ST ST
IDAHO FALLS, ID 83401-3928
Phone number: 208-419-0896
Mailing Address
TETON OUTPATIENT, LLC
403 1ST ST
IDAHO FALLS, ID 83401-3928
Phone number: 208-419-0896