| NPI | 1558452268 |
|---|---|
| Doing Business As | CLEARWATER MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CELSO R CHAVEZ Owner Physician 208-743-8416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NP361A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID A87025) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP740A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP751A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP372A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP388A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP390A) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-12-16 |