| NPI | 1356942437 |
|---|---|
| Doing Business As | IDAHO SKIN INSTITUTE OF REXBURG |
| Entity Type | Organization |
| Authorized Contact | RALENE REDFORD Practice Manager 208-238-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |