| NPI | 1508086018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C SIMON President 208-535-4420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: ID M6825) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |