| NPI | 1306862503 |
|---|---|
| Doing Business As | MOUNTAIN STATES CARDIOVASCULAR AND THORACIC SURGERY, PLLC |
| Entity Type | Organization |
| Authorized Contact | LISA A ALCOX Office Manager 208-524-4660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ID M-6479 M-7194) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |