NPI 1003564998

Magic Valley Pain Specialists, PLLC

Organisation Pain Medicine (Anesthesiology) Physician Burley, ID

Practice location

Address: 1344 Hiland Ave STE a, Burley, ID 83318-1564
Phone: (208) 678-7246
Mailing address: PO Box 50979, Idaho Falls, ID 83405-0979

Authorised official

Name: Tyler C Roe
Title: Owner
Phone: (208) 678-7246

Registered specialties

Pain Medicine (Anesthesiology) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207LP2900X

Other Anesthesiology providers in Idaho →

Registry record

NPI: 1003564998
Entity type: Organization
NPI issued: 10 Mar 2022
Record last updated: 27 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.