| NPI | 1578955621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GLENN DALLING Attending Orthopedic Surgeon 208-522-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2023-10-12 |