| Wolf Pack Llc | |
|
939 S 25th E Ste 115 Ammon ID 83406-5736 | |
| (208) 523-1209 | |
| Not Available |
| Full Name | Wolf Pack Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 939 S 25th E Ste 115, Ammon, Idaho |
| Authorized Official Name and Position | Shawn Tolman (CEO) |
| Authorized Official Contact | 2083131089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wolf Pack Llc 939 S 25th E Ste 115 Ammon ID 83406-5736 Ph: (208) 523-1209 | Wolf Pack Llc 939 S 25th E Ste 115 Ammon ID 83406-5736 Ph: (208) 523-1209 |
| NPI Number | 1992323216 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 07/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992323216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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