| NPI | 1417326968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WHITE Office Manager 208-452-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-10556) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID M-10864) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |