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General NPI Number Information
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NPI Number | 1164843215
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Entity Type | Organization
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Legal Business Name | SELAH MIDWIFERY CENTER
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Dates
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Enumeration Date | 12/16/2013
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 297 N 3855 E
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City | RIGBY
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State | ID
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Zip | 83442-5124
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Country | US
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Telephone | 208-745-7571
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Fax | 208-745-8924
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Provider Business Mailing Address
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Address Line | 97 N 4142 E
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City | RIGBY
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State | ID
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Zip | 83442-5142
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Country | US
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Telephone | 208-351-6548
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Fax | 208-745-8924
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | CHRISTINE ELIZABETH GARCIA
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Credential |
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Telephone | 208-351-6548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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