| NPI | 1053703850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LYNN OPDYCKE Clinical Director/Co Owner 208-737-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID Np336A) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |