| Premise Health Of Colorado Medical, P.c. | |
|
126 E 21st St Burley ID 83318-2551 | |
| (208) 678-2192 | |
| (208) 678-6077 |
| Full Name | Premise Health Of Colorado Medical, P.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 126 E 21st St, Burley, Idaho |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Colorado Medical, P.c. 5500 Maryland Way Ste 400 Brentwood TN 37027-7048 Ph: () - | Premise Health Of Colorado Medical, P.c. 126 E 21st St Burley ID 83318-2551 Ph: (208) 678-2192 |
| NPI Number | 1235618331 |
|---|---|
| Provider Enumeration Date | 08/09/2018 |
| Last Update Date | 09/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235618331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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