Eastern Idaho Spine Center in Idaho Falls - Rehabilitation Practitioner
Eastern Idaho Spine Center - NPI 1154593705
Eastern Idaho Spine Center is a Rehabilitation Practitioner in Idaho Falls, Idaho. Eastern Idaho Spine Center practices all healthcare services and medical treatments related to Rehabilitation Practitioner. The NPI Number for Eastern Idaho Spine Center is 1154593705. The last update date is 2008-06-06.
Eastern Idaho Spine Center's current location address is 2860 Channing Way, Idaho Falls, Idaho. You can contact this provider via phone number 2085354343 and fax number 2085354344. The mailing address for Eastern Idaho Spine Center is 2860 Channing Way, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eastern Idaho Spine Center |
|---|---|
| Address | 2860 Channing Way, Idaho Falls, Idaho |
| Phone Number | 2085354343 |
| Fax Number | 2085354344 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Mangrum Christian Shane |
| Credentials | M.D. |
| Telephone Number | 2085354343 |
NPI Number Detail
| NPI Number | 1154593705 |
|---|---|
| Provider Enumeration Date | 2008-03-24 |
| Last Updated Date | 2008-06-06 |
Provider Mailing Address Detail
| Address | 2860 Channing Way |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834047531 |
| Phone Number | 2085354343 |
| Fax Number | 2085354344 |
Provider's Primary Taxonomy Detail
| Speciality | Rehabilitation Practitioner |
|---|---|
| Taxonomy | 225400000X |
|
Definition: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8079840 | ID | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Eastern Idaho Spine Center by the Centers for Medicare & Medicaid Services?
The Eastern Idaho Spine Center has been assigned the NPI (National Provider Identifier) 1154593705 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Eastern Idaho Spine Center?
The Eastern Idaho Spine Center is situated at 2860 Channing Way, in the city of Idaho Falls, state of ID, with the zip code 834047531.
What is Eastern Idaho Spine Center's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Eastern Idaho Spine Center is Rehabilitation Practitioner, and the taxonomy code that classifies this field of practice is 225400000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1154593705 to Eastern Idaho Spine Center?
The Centers for Medicare & Medicaid Services assigned the 1154593705 to Eastern Idaho Spine Center on 2008-03-24.
When was the information related to Eastern Idaho Spine Center most recently updated or refreshed?
The details pertaining to the Eastern Idaho Spine Center, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-06-06.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC