Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-02-13
- Last updated
- 2020-07-20
Specialties
Licenses
- License ID
- RC-772
Location
- Practice location
- 4080 HAWTHORNE ROAD
- City
- CHUBBUCK ID
- Postal code
- 83202
- Phone
- 208-237-3000
Organization contact
- Name
- JOANNE LESKOWICZ
- Title
- Senior Vice President
- Phone
- 4149185000
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.