| NPI | 1285464529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADE A FORBUSH Owner 208-539-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2025-02-10 |