NPI | 1649699216 |
---|---|
Doing Business As | SHELLEY FAMILY MEDICAL CENTER |
Entity Type | Organization |
Authorized Contact | NED HILLYARD Chief Compliance Officer 208-557-2711 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
363A00000X Physician Assistant | |
Enumeration Date | 2014-04-10 |
Last Update Date | 2016-04-21 |