| NPI | 1114220324 |
|---|---|
| Doing Business As | EASTERN IDAHO NEUROLOGY |
| Entity Type | Organization |
| Authorized Contact | DOUG CRABTREE CEO 208-529-6111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ID 193400000X) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2018-08-27 |