| NPI | 1548930878 |
|---|---|
| Doing Business As | LAKEVIEW MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHERI HENDERSON Credentialing Specialist 208-547-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2021-09-17 |