| NPI | 1134620107 |
|---|---|
| Other Name | BLAIR FAMILY MEDICINE |
| Doing Business As | BLAIR FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DEREK M VAN ORDEN Practice Manager 208-357-4633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2022-11-22 |