| NPI | 1073559449 |
|---|---|
| Doing Business As | SAINT ALPHONSUS MEDICAL GROUP SHORELINE |
| Entity Type | Organization |
| Authorized Contact | JANELLE G. REILLY President 208-367-6490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-12-24 |