| NPI | 1639059512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LYNN EVANS Owner 208-826-1054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |