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General NPI Number Information
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NPI Number | 1508105149
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Entity Type | Organization
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Legal Business Name | THE UMA CENTER, LLC
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 414 S JEFFERSON ST
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City | MOSCOW
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State | ID
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Zip | 83843-2937
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Country | US
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Telephone | 208-596-2557
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Fax |
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Provider Business Mailing Address
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Address Line | 407 N POLK ST
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City | MOSCOW
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State | ID
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Zip | 83843-2748
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Country | US
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Telephone | 208-596-2557
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | NICOLE WERNER
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Credential | PHD
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Telephone | 208-596-2557
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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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