| NPI | 1013955178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL CALVIN COLLINS Md/Owner 208-287-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: ID M4426) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2013-07-13 |