National Provider Identifier Database

ROCKY MOUNTAIN WELLNESS CLINIC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

ROCKY MOUNTAIN WELLNESS CLINIC
2065 E 17TH ST STE A
IDAHO FALLS, ID83404-8042
Phone: 208-497-0541
Fax: 208-497-0873
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for ROCKY MOUNTAIN WELLNESS CLINIC

NPI Number 1326915000
Legal business name
LBN
ROCKY MOUNTAIN WELLNESS CLINIC
Authorized official KYLEE JOHNSON - (OWNER/PROVIDER)
Entity Organization
Organization subpart No
Enumeration date 10/20/2025
Last updated 10/20/2025 - About 8 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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