| NPI | 1063143659 |
|---|---|
| Doing Business As | WELLNESS AND AESTHETICS CLINIC OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA MWANGA Medical Director 208-380-9906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2024-12-20 |