OrganizationActive
Idaho Allergy & Asthma Clinic PA
NPI 1003949298 · Allergy & Immunology Physician · Idaho Falls, ID
Provider details
- NPI number
- 1003949298
- Entity type
- Organization
- Primary specialty
- Allergy & Immunology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Wendell Petty, President(208) 529-9292
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3422 S 15th E
Idaho Falls, ID 83404-8262
Phone: (208) 529-9292
Fax: (208) 523-2397
Approximate (ZIP-level) locationGet directions
Mailing address
3422 S 15th E
Idaho Falls, ID 83404-8262
Registry dates
- Enumerated
- 2007-03-14
- Last updated
- 2019-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.