| NPI | 1467583153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT KARL MAGNUSON Physician 208-664-2363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: ID M7860) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2023-03-14 |