NPI | 1295890648 |
---|---|
Doing Business As | SOUTH IDAHO FOOT AND ANKLE CLINIC |
Entity Type | Organization |
Authorized Contact | DAVID A BLACKMER Owner 208-733-3881 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Enumeration Date | 2006-12-26 |
Last Update Date | 2011-03-28 |