| NPI | 1548741820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE GRIMM Family Nurse Practitioner/Owner 208-946-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: ID NP1113A) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2018-09-18 |