| NPI | 1205869310 |
|---|---|
| Doing Business As | INTERMOUNTAIN MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHELLY STRANSKI Administrator 208-238-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2015-05-28 |