Graduated: 1987
NPI: 1013931450
Practice Locations (2)
MOUNTAIN VIEW HOSPITAL LLC
2325 CORONADO ST
IDAHO FALLS, ID 834047407
2085572700
IDAHO STATE UNIVERSITY
650 MEMORIAL DR BLDG, 68 ISU SPEECH AND HEARING CLINIC
POCATELLO, ID 832098116
2082823495
Source: CMS National Downloadable File, September 2026.