GRAND TETON CHILD NEUROLOGY is a neurology with special qualifications in child neurology psychiatry neurology in Idaho Falls, ID. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. GRAND TETON CHILD NEUROLOGY NPI is 1639322258. The provider is registered as an organization entity type.
The provider's business location address is:
2225 TETON PLZ STE B
IDAHO FALLS, ID
ZIP 83404-494
Phone: (208) 529-4300
Fax: (208) 529-1627
The provider's authorized official is Peter W Castellanos .
The authorized official title is Neurologist and has the following contact phone number (208) 529-4300.
The CLIA number assigned to this NPI record is 13D2057441 - other - clinical research site with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/28/2008 and was last updated on 8/17/2021.