IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE

POCATELLO, ID
NPI1780032326
Entity TypeOrganization
Authorized ContactLAURIE POWELL
Authorization Specialist
208-232-6260
Organization Subpart ?Yes
Primary Taxonomy251S00000X 
Enumeration Date2016-05-24
Last Update Date2016-05-24
Business Address
IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE
465 MEMORIAL DR
POCATELLO, ID 83201-4008
Phone number: 208-282-4141
Mailing Address
IDAHO STATE UNIVERSITY DEPARTMENT OF FAMILY MEDICINE
1000 N 8TH AVE
POCATELLO, ID 83201-5757
Phone number: 208-232-6260
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