Grand Teton Child Neurology
Grand Teton Child Neurology provides Neurology with Special Qualifications in Child Neurology Physician services in Idaho Falls, Idaho. Registered with an NPI since 2008.
- In the registry since
- 2008
- Specialties on file
- 2
Practice location Address checks out
2225 Teton Plz Ste BIdaho Falls, ID 83404-6494
Phone: (208) 529-4300
Fax: (208) 529-1627
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Specialties & licences
| Neurology with Special Qualifications in Child Neurology Physician (primary) | Taxonomy 2084N0402X |
|---|---|
| Community/Behavioral Health Agency | Taxonomy 251S00000X |
Record details
| NPI number | 1639322258 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Peter Castellanos — Neurologist · (208) 529-4300 |
| NPI enumerated | October 28, 2008 |
| Last updated in NPPES | August 17, 2021 |
| Certification date | August 17, 2021 |
| Mailing address | 2225 Teton Plz Ste B, Idaho Falls, ID 83404-6494 |
Other providers in Idaho Falls
-
Peter W Castellanos, MD
2225 Teton Plz Ste B, Idaho Falls, ID 83404-6494 · (208) 529-4300