Mountain Country Family Healthcare, Pllc | |
31911 N 5th Ave Spirit Lake ID 83869 | |
(208) 610-7103 | |
Not Available |
Full Name | Mountain Country Family Healthcare, Pllc |
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Speciality | Clinic/center - Primary Care |
Location | 31911 N 5th Ave, Spirit Lake, Idaho |
Authorized Official Name and Position | Lana Rochelle Young (OWNER) |
Authorized Official Contact | 2086107103 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mountain Country Family Healthcare, Pllc Po Box 1671 Spirit Lake ID 83869-1605 Ph: (208) 610-7103 | Mountain Country Family Healthcare, Pllc 31911 N 5th Ave Spirit Lake ID 83869 Ph: (208) 610-7103 |
NPI Number | 1447801451 |
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Provider Enumeration Date | 09/23/2019 |
Last Update Date | 09/23/2019 |
Identifier | Type | State | Issuer |
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1447801451 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |