| NPI | 1255659561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A DURKIN Credentialing Manager 208-664-4026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD000458184) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00044796) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00046189) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |