| NPI | 1144720061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ALICE ELIZABETH JAEGER President 208-758-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2023-06-01 |