Organization · Type 2 NPI
Payette Lakes Medical Clinic, PA
Primary Care Clinic/Center · Donnelly, ID
NPI number
1902937196
Active
Practice location
454 Rosebury Road, Suite 103
Donnelly, ID 83615
Fax (208) 325-4466
Mailing address
PO Box 1047
Mccall, ID 83638-1047
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1902937196
Payette Lakes Medical Clinic, PA's National Provider Identifier is 1902937196, issued on Mar 8, 2007. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Donnelly, ID. The record was last updated on Mar 17, 2008.