| NPI | 1629145685 |
|---|---|
| Other Name | IDAHO EYE SURGICENTER |
| Entity Type | Organization |
| Authorized Contact | BRADLEY P GARDNER Senior Vice President 208-524-2025 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-08-12 |