| Lifestar Pocatello And Idaho Falls | |
|
730 E Clark St # 4571 Pocatello ID 83201-6238 | |
| (208) 520-9649 | |
| Not Available |
| Full Name | Lifestar Pocatello And Idaho Falls |
|---|---|
| Speciality | Counselor |
| Location | 730 E Clark St # 4571, Pocatello, Idaho |
| Authorized Official Name and Position | David Covey (OWNER) |
| Authorized Official Contact | 2085209649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestar Pocatello And Idaho Falls 730 E Clark St # 4571 Pocatello ID 83201-6238 Ph: (208) 520-9649 | Lifestar Pocatello And Idaho Falls 730 E Clark St # 4571 Pocatello ID 83201-6238 Ph: (208) 520-9649 |
| NPI Number | 1255602983 |
|---|---|
| Provider Enumeration Date | 01/26/2012 |
| Last Update Date | 02/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255602983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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