| NPI | 1235381948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY NEY Billing Manager 208-455-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: ID 0-159) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |