| NPI | 1700898822 |
|---|---|
| Doing Business As | POCATELLO CHILDREN'S CLINIC |
| Entity Type | Organization |
| Authorized Contact | JESSICA PERRY Administrator 208-239-3400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-03-07 |