| NPI | 1407015282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD L TALCOTT Physician/Owner 208-552-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: ID M10044) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-07-15 |