| NPI | 1649748559 |
|---|---|
| Doing Business As | PHYSICIAN HOME CARE |
| Entity Type | Organization |
| Authorized Contact | LEE JOHNSON Treasurer 208-401-1369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2022-04-01 |