| NPI | 1407894041 |
|---|---|
| Doing Business As | SOUTHERN IDAHO VEIN CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | BRUCE C MCCOMAS Physician 208-734-3596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: ID M5070) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2013-03-09 |