| NPI | 1275721912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL HERROLD Owner, President, Physician 208-343-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ID M7321) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2025-06-09 |