| NPI | 1609966951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLIS CORBIN Business Office Manager 208-765-3288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2012-04-05 |