| NPI | 1194735522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY D QUINTON Owner 208-529-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: ID P 186) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |