Graduated: 2016
NPI: 1689022519
Practice Locations (2)
COMMUNITY CARE WEST SIDE LLC
765 S UTAH AVE
IDAHO FALLS, ID 834025093
2085852600
CARIBOU MEDICAL CENTER, INC
300 S 3RD
SODA SPRINGS, ID 832761559
20854733417503
Source: CMS National Downloadable File, September 2026.