OrganizationActive
Mountain Telerad, PLLC
NPI 1821280371 · Radiologic Technologist · Caldwell, ID
Provider details
- NPI number
- 1821280371
- Entity type
- Organization
- Primary specialty
- Radiologic TechnologistTechnologists, Technicians & Other Technical Service Providers
- Organization subpart
- No
- Authorized official
- Micheal Johnson, Owner(208) 455-7482
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
4519 Enterprise Way
Caldwell, ID 83605
Phone: (208) 455-7482
Fax: (208) 455-7538
Approximate (ZIP-level) locationGet directions
Mailing address
141 Victor Gust Dr
Mountain Home, ID 83647-1654
Registry dates
- Enumerated
- 2007-08-17
- Last updated
- 2007-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.