| NPI | 1245824929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACY MARLATT Owner/Partner 208-902-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center Radiology |
| Additional Taxonomies | 2085U0001X Radiology Diagnostic Ultrasound |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2023-01-03 |