| NPI | 1285271635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATY CONNLEY CEO, Owner 208-830-6773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2021-03-23 |