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Court Church
NPI 1588987812 · on the registry since 2010
Practice
- Address
- 2725 E 17th St
Ammon, ID 83406 - Phone
- (208) 529-4567
- Organisation at this address
- Gem Medical Investors, Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 225X00000X
225X00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-03-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho