NPI 1033417035

Idaho Sports & Spine PLLC

Organisation Sports Medicine (Family Medicine) Physician Pocatello, ID

Practice location

Address: 950 Hospital Way STE a, Pocatello, ID 83201-2789
Phone: (208) 478-4522
Fax: (208) 478-2935

Authorised official

Name: Stephen Hansen
Title: Owner
Phone: (208) 478-4522

Registered specialties

Sports Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QS0010X Licence O-0400 (ID)

Other Family Medicine providers in Idaho →

Registry record

NPI: 1033417035
Entity type: Organization
NPI issued: 1 Mar 2011
Record last updated: 4 Nov 2019

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.