| |
229 S 7th St, St Maries, ID 83861-1803 | |
(509) 924-2600 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Podiatrist |
Location | 229 S 7th St, St Maries, Idaho |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770013443 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | P-224 (Idaho) | Primary |
261QA1903X | Clinic/center - Ambulatory Surgical | 6011706837 (Washington) | Secondary |
Mailing Address | Practice Location Address |
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526 N Mullan Rd, Spokane Valley, WA 99206-2408 Ph: (509) 924-2600 | 229 S 7th St, St Maries, ID 83861-1803 Ph: (509) 924-2600 |