| NPI | 1538517156 |
|---|---|
| Doing Business As | COMMUNITY CARE POCATELLO |
| Entity Type | Organization |
| Authorized Contact | JOSHUA TOLMAN CAO 208-557-2700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |