NPI | 1447894399 |
---|---|
Entity Type | Organization |
Authorized Contact | CORBIN BUNNAGE Provider/Owner 208-542-9111 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
261QX0100X Clinic/Center Occupational Medicine | |
Enumeration Date | 2019-11-04 |
Last Update Date | 2024-07-27 |