| NPI | 1154188050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW FOWLER Nurse Practitioner/Owner 208-546-3650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |