Medical school: ROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduated: 2024
NPI: 1740020148
Practice Locations (3)
1754 W 1500
MALAD CITY, ID 832526594
PO BOX, SUITE 4168
POCATELLO, ID 83205
PO BOX, SUITE 4168
POCATELLO, ID 832054168
Source: CMS National Downloadable File, September 2026.