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Matt Wrathall, CM
Pain Clinic/Center in Menan, Idaho
NPI 1205612405

Matt Wrathall is a Pain Clinic/Center based in Menan, ID and is specialized in Pain. Matt Wrathall practices in Menan, ID and has the professional credentials of CM. The NPI Number for Matt Wrathall is 1205612405 and holds a License No. (Idaho).

The current practice location address for Matt Wrathall is 3672 E Menan Lorenzo Hwy, Menan, ID and can be reached out via phone at 208-220-6344.

Location: 3672 E Menan Lorenzo Hwy, Menan, ID, 83434-0151
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205612405
Provider Name
Matt Wrathall
Credential
CM
Provider Entity Type
Individual
Gender
Male
Address
3672 E Menan Lorenzo Hwy, Menan, ID, 83434-0151
Phone Number
208-220-6344
Fax Number
Provider Enumeration Date
09/04/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3672 E Menan Lorenzo Hwy
City
Menan
State
Idaho
Zip
83434-5204
Phone Number
208-220-6344
Fax Number
person
Provider Business Mailing Address Details
Address
3672 E Menan Lorenzo Hwy
City
Menan
State
Idaho
Zip
83434-5204
Phone Number
208-220-6344
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Pain
Taxonomy
261QP3300X
License No.
(Arizona)
Definition
Definition to come...
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