| Precision Family Medicine & Aesthetics Llc | |
|
2001 S Woodruff Ave Ste 11 Idaho Falls ID 83404-6372 | |
| (208) 757-1000 | |
| Not Available |
| Full Name | Precision Family Medicine & Aesthetics Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2001 S Woodruff Ave Ste 11, Idaho Falls, Idaho |
| Authorized Official Name and Position | Bradley Radford (OWNER) |
| Authorized Official Contact | 2084193271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Precision Family Medicine & Aesthetics Llc 2001 S Woodruff Ave Ste 11 Idaho Falls ID 83404-6372 Ph: () - | Precision Family Medicine & Aesthetics Llc 2001 S Woodruff Ave Ste 11 Idaho Falls ID 83404-6372 Ph: (208) 757-1000 |
| NPI Number | 1760119986 |
|---|---|
| Provider Enumeration Date | 08/07/2022 |
| Last Update Date | 10/13/2022 |
| Medicare PECOS PAC ID | 4880060185 |
|---|---|
| Medicare Enrollment ID | O20221011001923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760119986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lynne J Trauntvein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558624601 PECOS PAC ID: 8426294505 Enrollment ID: I20130416000094 |
| Provider Name | Bradley J Radford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871191254 PECOS PAC ID: 5890105928 Enrollment ID: I20201102000294 |
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