| NPI | 1235682121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH LOWTHER Clinical Director 208-541-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: ID 363LF0000X) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |