| NPI | 1306608104 |
|---|---|
| Doing Business As | IDAHO LUNG AND HEART |
| Entity Type | Organization |
| Authorized Contact | BRADLEY S CORDERO Owner 208-359-9570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2025-02-04 |