| NPI | 1174711758 |
|---|---|
| Doing Business As | FAMILY FIRST HEALTH CENTERS SOUTH |
| Entity Type | Organization |
| Authorized Contact | ROGER SCOTT MALM Owner 208-238-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: ID PA220) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |