| NPI | 1134404718 |
|---|---|
| Doing Business As | EAST IDAHO INTERVENTIONAL PAIN CENTER |
| Entity Type | Organization |
| Authorized Contact | HOLLY ZOE Owner 208-234-2345 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |