NPI 1144783499

Mountain States Diabetes Relief, LLC

Organisation Endocrinology, Diabetes & Metabolism Physician Idaho Falls, ID

Practice location

Address: 4573 E Majestic, Idaho Falls, ID 83406
Phone: (208) 520-2636

Authorised official

Name: Katie Davenport
Title: Partner
Phone: (208) 520-2636

Registered specialties

Endocrinology, Diabetes & Metabolism Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207RE0101X

Other Internal Medicine providers in Idaho →

Registry record

NPI: 1144783499
Entity type: Organization
NPI issued: 12 Apr 2019
Record last updated: 12 Apr 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.