| NPI | 1063769297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON GILBERT Owner 208-339-4355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: ID P-64) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |