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General NPI Number Information
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NPI Number | 1912723214
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Entity Type | Organization
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Legal Business Name | FAMILY PRACTICE GROUP, P.A.
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 1951 BENCH RD STE D
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City | POCATELLO
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State | ID
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Zip | 83201-2073
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Country | US
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Telephone | 208-238-1000
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Fax | 208-238-0009
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Provider Business Mailing Address
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Address Line | 1951 BENCH RD STE B
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City | POCATELLO
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State | ID
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Zip | 83201-2073
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Country | US
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Telephone | 208-238-1000
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Fax | 208-238-0009
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Authorized Official
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Title or Position | CPC
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Name | JANETTE ROPICKY
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Credential |
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Telephone | 208-238-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0404X
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Taxonomy Name | Cardiac Rehabilitation Clinic/Center
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License Number |
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License Number State |
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