| Community Care Pllc | |
|
1995 E 17th St Idaho Falls ID 83404-6493 | |
| (208) 529-5252 | |
| (208) 529-4434 |
| Full Name | Community Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1995 E 17th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Ryan Peterson (DEO) |
| Authorized Official Contact | 2085258448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Pllc 1995 E 17th St Idaho Falls ID 83404-6493 Ph: (208) 529-5252 | Community Care Pllc 1995 E 17th St Idaho Falls ID 83404-6493 Ph: (208) 529-5252 |
| NPI Number | 1205846425 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205846425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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