| NPI | 1659380269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER COOPER Office Asst Administrator 208-855-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-10-04 |