| NPI | 1629275318 |
|---|---|
| Doing Business As | BLACKFOOT ORTHOPEDIC CENTER |
| Entity Type | Organization |
| Authorized Contact | LISA RUDOLPH Pso Support Specialist 208-782-3992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2009-02-18 |