| NPI | 1114691813 |
|---|---|
| Doing Business As | IDAHO SKIN INSTITUTE OF TWIN FALLS |
| Entity Type | Organization |
| Authorized Contact | EARL R STODDARD Owner 208-238-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2023-07-25 |