| NPI | 1114445087 |
|---|---|
| Doing Business As | IDAHO ORTHOPAEDIC & SPORTS CLINIC, P.A. |
| Entity Type | Organization |
| Authorized Contact | D. JEFF DANIELS CEO 208-785-3803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-08-31 |