NPI | 1487260550 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTINA LYNN PIKE Administrator 208-985-2260 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2020-09-23 |
Last Update Date | 2020-10-15 |