OrganizationActive
Grand Teton Child Neurology
NPI 1639322258 · Neurology with Special Qualifications in Child Neurology Physician · Idaho Falls, ID
Provider details
- NPI number
- 1639322258
- Entity type
- Organization
- Primary specialty
- Neurology with Special Qualifications in Child Neurology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Peter Castellanos, Neurologist(208) 529-4300
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Community/Behavioral Health Agency251S00000X
Agencies
Practice location
2225 Teton Plz Ste B
Idaho Falls, ID 83404-6494
Phone: (208) 529-4300
Fax: (208) 529-1627
Approximate (ZIP-level) locationGet directions
Mailing address
2225 Teton Plz Ste B
Idaho Falls, ID 83404-6494
Registry dates
- Enumerated
- 2008-10-28
- Last updated
- 2021-08-17
- Certified
- 2021-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.