| NPI | 1023024684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINTON MALLARI Administrator 208-342-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-19 |