NPI | 1144504663 |
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Doing Business As | PHYSICIANS IMMEDIATE CARE CENTER |
Entity Type | Organization |
Authorized Contact | RANDY VAWDREY COO 208-232-0021 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2011-10-03 |
Last Update Date | 2011-10-03 |