| NPI | 1437210994 |
|---|---|
| Doing Business As | MOUNTAIN WEST DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | MARK ELDON HINKSON President 208-528-6653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID O-323) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |