| NPI | 1376160457 |
|---|---|
| Doing Business As | NORTH CANYON JEROME CLINIC |
| Entity Type | Organization |
| Authorized Contact | SARA DEMOE CFO 208-934-9695 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2021-01-29 |