| NPI | 1477883296 |
|---|---|
| Doing Business As | LIFESPAN FAMILY PRACTICE, LLC |
| Entity Type | Organization |
| Authorized Contact | WENDY LEE MCKNIGHT Owner 208-736-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2011-03-28 |