Organization Name: | RIGHT CHOICE URGENT CARE AND FAMILY MEDICINE |
NPI Number: | 1598005233 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY D MYERS (OWNER) |
Mailing Address: | 280 W Main St Wendell |
State: | ID US |
Postal Code: | 833555201 |
Phone Number: | 2085369933 |
Fax Number: | 2085366214 |
NPI Enumeration Date: | 02/16/2013 |
NPI Last Update Date: | 02/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA-368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |