| NPI | 1376835363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L CHANDLER Podiatrist 208-344-3324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID P-73) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-17 |