| NPI | 1215581780 |
|---|---|
| Doing Business As | ALL STAR PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | BRANDY NICOLE WELCH Physician/Owner 208-830-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |