| NPI | 1487693032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL R GLEASON Clinic Administrator 208-375-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-06-16 |