| NPI | 1588802391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL R MARSHALL Owner, CEO 208-359-4841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: ID O-0508) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2019-04-05 |