| NPI | 1124741277 |
|---|---|
| Former Legal Business Name | ANDERSEN FAMILY CARE P.L.L.C |
| Entity Type | Organization |
| Authorized Contact | DALLIN ANDERSEN Owner 208-954-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-09-28 |