| NPI | 1487151882 |
|---|---|
| Other Name | C/O PHYSICIANS IMMEIDATE CARE OF TWIN |
| Entity Type | Organization |
| Authorized Contact | JEREMY B HAYMORE Medical Director 208-312-2242 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-4391) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2019-02-01 |