NPI | 1437504909 |
---|---|
Doing Business As | ACACIA WELLNESS CENTER |
Entity Type | Organization |
Authorized Contact | DEO MARIE PEPPERSACK Owner 208-498-1760 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2016-05-03 |
Last Update Date | 2016-05-03 |