| NPI | 1275516718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN REED SONNTAG Medical Director 208-377-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2011-10-07 |