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 |