| NPI | 1033259700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT SCHRADER President 208-736-4568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA271) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2010-01-15 |