| NPI | 1508922303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J COUGHLIN Physician 208-377-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: ID M3906) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |