| NPI | 1548751563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CRAWFORD Owner 208-938-5823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: ID M-14198) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2022-05-19 |