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General NPI Number Information
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NPI Number | 1205856481
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Entity Type | Organization
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Legal Business Name | CSA OF POST FALLS
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 750 N SYRINGA ST SUITE 102
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City | POST FALLS
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State | ID
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Zip | 83854-5275
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Country | US
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Telephone | 208-777-9877
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Fax | 208-777-9833
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Provider Business Mailing Address
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Address Line | 750 N SYRINGA AVE SUITE 102
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 208-777-9877
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Fax | 208-777-9833
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JOHN COMBS
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Credential | BS, RT (R)(CV)
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Telephone | 509-232-0567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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