| NPI | 1619539897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOSEPH MONTALBANO Owner 208-327-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2022-05-09 |