| NPI | 1659870517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA J SMITH Practice Administrator 208-233-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |