NPI 1124198403

Greenwald Neurosurgical

Organisation Specialist Idaho Falls, ID

Practice location

Address: 3155 Channing Way Suite B, Idaho Falls, ID 83404-7546
Phone: (208) 535-4800
Fax: (208) 535-4807

Authorised official

Name: Janeene a Ditmore
Title: Office Manager
Phone: (208) 535-4800

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence M-6947 (ID)

Other Specialist providers in Idaho →

Registry record

NPI: 1124198403
Entity type: Organization
NPI issued: 8 Nov 2006
Record last updated: 13 Jul 2009

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.