| Alpine Integrated Wellness | |
|
220 River St E Suite D Ketchum ID 83340 | |
| (503) 936-0379 | |
| (413) 677-2481 |
| Full Name | Alpine Integrated Wellness |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 220 River St E, Ketchum, Idaho |
| Authorized Official Name and Position | Daniel Jacob Rothman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5039360379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpine Integrated Wellness Po Box 533 Ketchum ID 83340-0481 Ph: (503) 936-0379 | Alpine Integrated Wellness 220 River St E Suite D Ketchum ID 83340 Ph: (503) 936-0379 |
| NPI Number | 1396385845 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 01/13/2020 |
| Certification Date | 01/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396385845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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