| NPI | 1124061163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN WASILWESKI Physician 208-726-5207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-06-17 |