| NPI | 1598107815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS JAY KEMP CEO/Owner 208-473-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: ID M-10673) |
| Enumeration Date | 2013-07-28 |
| Last Update Date | 2013-07-28 |