MOUNTAIN TELERAD, PLLC is a radiologic technologist in Caldwell, ID. The provider is an individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. MOUNTAIN TELERAD, PLLC NPI is 1821280371. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
4519 ENTERPRISE WAY
CALDWELL, ID
ZIP 83605
Phone: (208) 455-7482
Fax: (208) 455-7538
The provider's authorized official is Micheal Brent Johnson .
The authorized official title is Owner and has the following contact phone number (208) 455-7482.
The CLIA number assigned to this NPI record is 13D0521221 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 8/17/2007 and was last updated on 8/17/2007.