NPI 1225365992

Eastern Idaho Foot Clinic

Organisation Durable Medical Equipment & Medical Supplies Idaho Falls, ID

Practice location

Address: 2565 Channing Way, Idaho Falls, ID 83404-7516
Phone: (208) 523-2928
Fax: (208) 523-2962

Authorised official

Name: Jerry D. Cooper
Title: Owner
Phone: (208) 523-2928

Registered specialties

Durable Medical Equipment & Medical Supplies Primary

Suppliers Taxonomy 332B00000X Licence P126 (ID)

Other Durable Medical Equipment & Medical Supplies providers in Idaho →

Registry record

NPI: 1225365992
Entity type: Organization
NPI issued: 17 Nov 2009
Record last updated: 17 Nov 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.