| NPI | 1396121349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA LAUREN MILLER Family Nurse Practitioner 208-939-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |