| NPI | 1083937049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE MICHELLE ELSTUN President And Medical Director 208-938-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-9150) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID LCPC-2918) |
| 111N00000X Chiropractor (Licence: ID CHIA-1198) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2010-03-04 |