| NPI | 1497768626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE G TOLMAN Owner 208-529-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: ID 1870101) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2008-06-19 |