| Lifestar Rexburg | |
|
402 W 4th S Rexburg ID 83440-2640 | |
| (208) 313-7464 | |
| Not Available |
| Full Name | Lifestar Rexburg |
|---|---|
| Speciality | Counselor |
| Location | 402 W 4th S, Rexburg, Idaho |
| Authorized Official Name and Position | Rosemary Smith (CO-OWNER) |
| Authorized Official Contact | 2083137464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestar Rexburg 402 W 4th S Rexburg ID 83440-2640 Ph: (208) 313-7464 | Lifestar Rexburg 402 W 4th S Rexburg ID 83440-2640 Ph: (208) 313-7464 |
| NPI Number | 1568736049 |
|---|---|
| Provider Enumeration Date | 03/01/2012 |
| Last Update Date | 03/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568736049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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