| NPI | 1043927882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIE RATH Mananger 208-795-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2024-01-16 |