OrganizationActive
Mountain States Diabetes Relief, LLC
NPI 1144783499 · Endocrinology, Diabetes & Metabolism Physician · Idaho Falls, ID
Provider details
- NPI number
- 1144783499
- Entity type
- Organization
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Katie Davenport, Partner(208) 520-2636
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4573 E Majestic
Idaho Falls, ID 83406
Phone: (208) 520-2636
Approximate (ZIP-level) locationGet directions
Mailing address
4573 E Majestic
Idaho Falls, ID 83406
Registry dates
- Enumerated
- 2019-04-12
- Last updated
- 2019-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.