| Mountain Country Family Healthcare, Pllc | |
|
31911 N 5th Ave Spirit Lake ID 83869 | |
| (208) 610-7103 | |
| Not Available |
| Full Name | Mountain Country Family Healthcare, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 31911 N 5th Ave, Spirit Lake, Idaho |
| Authorized Official Name and Position | Lana Rochelle Young (OWNER) |
| Authorized Official Contact | 2086107103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Country Family Healthcare, Pllc Po Box 1671 Spirit Lake ID 83869-1605 Ph: (208) 610-7103 | Mountain Country Family Healthcare, Pllc 31911 N 5th Ave Spirit Lake ID 83869 Ph: (208) 610-7103 |
| NPI Number | 1447801451 |
|---|---|
| Provider Enumeration Date | 09/23/2019 |
| Last Update Date | 09/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447801451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |