NPI | 1477295632 |
---|---|
Entity Type | Organization |
Authorized Contact | KYLE JAMES Co Owner 208-678-6996 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2022-04-08 |
Last Update Date | 2023-03-30 |