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General NPI Number Information
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NPI Number | 1649965336
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Entity Type | Organization
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Legal Business Name | MEDICAL SOLUTIONS HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 04/07/2023
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1550 N CRESTMONT DR
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City | MERIDIAN
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State | ID
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Zip | 83642-2184
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Country | US
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Telephone | 801-574-5277
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 N CRESMONT DR SUITE G
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-629-2023
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Fax | 208-759-5840
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. KIMBERLEY HELEN ODOM
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Credential | RNP-C
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Telephone | 801-574-5277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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