| NPI | 1013204445 |
|---|---|
| Doing Business As | SHANE G MACHEN, DO |
| Entity Type | Organization |
| Authorized Contact | SHANE G MACHEN Owner 208-522-7666 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0611) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2012-04-26 |