| NPI | 1649748559 |
|---|---|
| Doing Business As | PHYSICIAN HOME CARE |
| Entity Type | Organization |
| Authorized Contact | AMBER L TUELLER Secretary 208-207-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2025-05-28 |