| NPI | 1134219330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DEAN MCDONALD Owner 208-777-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: ID M-7768) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2015-04-09 |