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1528656659
EASTERN IDAHO INTENSIVIST LLC
IDAHO FALLS, ID
NPI
1528656659
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Entity Type
Organization
Authorized Contact
MIT DESAI
CEO
813-530-5043
Organization Subpart ?
No
Primary Taxonomy
207RC0200X Internal Medicine, Critical Care Medicine
Enumeration Date
2021-01-05
Last Update Date
2021-01-05
Business Address
EASTERN IDAHO INTENSIVIST LLC
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 813-940-7874
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Mailing Address
EASTERN IDAHO INTENSIVIST LLC
PO BOX 21647
TAMPA, FL 33622-1647
Phone number:
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