| NPI | 1285979757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HATCH Owner 208-538-3122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 111N00000X Chiropractor | |
| 171M00000X Case Manager/Care Coordinator | |
| 225100000X Physical Therapist | |
| 251S00000X | |
| 261QP3300X Clinic/Center, Pain | |
| 363A00000X Physician Assistant | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2020-10-26 |