NPI | 1639117153 |
---|---|
Former Legal Business Name | MCCONNEHEY FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | CHERYL D LUNDY Billing Manger 208-452-6794 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2006-06-04 |
Last Update Date | 2007-09-12 |