| NPI | 1376244061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA RODRIGUEZ Practice Manager 208-342-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2026-09-03 |