Blair K. Garner, Pa | |
2235 E 25th St Suite 185 Idaho Falls ID 83404-7519 | |
(208) 522-1904 | |
(208) 522-8847 |
Full Name | Blair K. Garner, Pa |
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Speciality | Community/Behavioral Health |
Location | 2235 E 25th St, Idaho Falls, Idaho |
Authorized Official Name and Position | Blair K Garner (PRESIDENT) |
Authorized Official Contact | 2085221904 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Blair K. Garner, Pa 2235 E 25th St Suite 185 Idaho Falls ID 83404-7519 Ph: (208) 522-1904 | Blair K. Garner, Pa 2235 E 25th St Suite 185 Idaho Falls ID 83404-7519 Ph: (208) 522-1904 |
NPI Number | 1851662852 |
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Provider Enumeration Date | 01/23/2012 |
Last Update Date | 01/23/2012 |
Medicare PECOS PAC ID | 0446427819 |
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Medicare Enrollment ID | O20120125000947 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851662852 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | LCSW-582 (Idaho) | Primary |
Provider Name | Blair K Garner |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1821148537 PECOS PAC ID: 6800063272 Enrollment ID: I20120125000955 |
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