De Loera, Madison Mckenzi
De Loera, Madison Mckenzi is an individual health care provider with primary practice located at 720 S Woodruff Ave , Idaho Falls ID 83401-5285. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. De Loera, Madison Mckenzi can be contacted via phone (208) 552-5025.Contact Information
Primary practice address
720 S Woodruff Ave
Idaho Falls ID 83401-5285
Phone: (208) 552-5025
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | PTA-6160 | Idaho |
Profile Details
| NPI number | 1740827385 |
|---|---|
| LBN Legal business name | De Loera, Madison Mckenzi |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2019 |
| Last updated | Dec 2nd, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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