| Total Life Clinic Pllc | |
|
2311 Park Ave Unit 2 Suite 6&8 Burley ID 83318-2104 | |
| (208) 878-6413 | |
| (208) 878-6417 |
| Full Name | Total Life Clinic Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2311 Park Ave, Burley, Idaho |
| Authorized Official Name and Position | Shelbyann Bernice Aldridge (OFFICE MANAGER) |
| Authorized Official Contact | 2088786413 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Life Clinic Pllc 2311 Park Ave Unit 2 Suite 6&8 Burley ID 83318-2104 Ph: (208) 878-6413 | Total Life Clinic Pllc 2311 Park Ave Unit 2 Suite 6&8 Burley ID 83318-2104 Ph: (208) 878-6413 |
| NPI Number | 1467816199 |
|---|---|
| Provider Enumeration Date | 04/08/2016 |
| Last Update Date | 03/16/2023 |
| Medicare PECOS PAC ID | 6305121336 |
|---|---|
| Medicare Enrollment ID | O20170314001070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467816199 | NPI | - | NPPES |
| 1467816199 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lacie S Asher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609107176 PECOS PAC ID: 5799978607 Enrollment ID: I20101025000230 |
Wayne H Blauer Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Ste L3, Burley, ID 83318 Phone: 208-678-2283 Fax: 208-677-2483 | |
Alan S. Nelson D.o. Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1404 Pomerelle Ave., Suite A2, Burley, ID 83318 Phone: 208-878-8817 | |
Premise Health Of Colorado Medical, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 E 21st St, Burley, ID 83318 Phone: 208-678-2192 Fax: 208-678-6077 | |
Ihc Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 521 E Main St, Burley, ID 83318 Phone: 208-677-6091 | |
Albion Valley Health Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 West 5th Street, Burley, ID 83318 Phone: 208-312-9740 Fax: 208-678-0910 | |
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