OrganizationActive
Teton Radiology Diagnostic, LLC
NPI 1194969725 · Body Imaging Physician · Idaho Falls, ID
Provider details
- NPI number
- 1194969725
- Entity type
- Organization
- Primary specialty
- Body Imaging PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Teton Radiology Diagnositc, LLC
- Authorized official
- Michael Hodel, General Manager
Practice location
2001 S Woodruff Ave Ste 17
Idaho Falls, ID 83404-6372
Phone: (208) 524-7237
Mailing address
Po Box 30015
Salt Lake City, UT 84130-0015
Registry dates
- Enumerated
- 2009-04-27
- Last updated
- 2026-01-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.