| NPI | 1316572563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JASON BROWN Chief Executive Officer 208-899-9631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-08-04 |