| Pathways Functional Medicine | |
|
401 Brockman Loop Jerome ID 83338 | |
| (208) 734-1394 | |
| Not Available |
| Full Name | Pathways Functional Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Brockman Loop, Jerome, Idaho |
| Authorized Official Name and Position | Elizabeth Jo Johnson (OWNER) |
| Authorized Official Contact | 2087341394 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways Functional Medicine 401 Brockman Loop Jerome ID 83338 Ph: (208) 734-1394 | Pathways Functional Medicine 401 Brockman Loop Jerome ID 83338 Ph: (208) 734-1394 |
| NPI Number | 1639867468 |
|---|---|
| Provider Enumeration Date | 04/28/2023 |
| Last Update Date | 04/28/2023 |
| Certification Date | 04/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639867468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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