NPI age
14 years
Enumerated 2011-10-12
● Active Type 2 · Organization
Teton Outpatient, Llc
Teton Outpatient, Llc is 1 of 32 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bryan
Owner
Last NPPES update
2011-10-12
Source: monthly bulk 2026-05
How this organization compares
Across 32 active clinic/center providers in Idaho.
NPI age
14 years
↓ 3 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2026
2011-10Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
403 1st St
Idaho Falls, ID 834013928
Mailing address
403 1st St
Idaho Falls, ID 834013928
Authorized official
Jacob Raymond Bryan, MOT
Owner
📞 2084190896
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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