NPI | 1669422242 |
---|---|
Entity Type | Organization |
Authorized Contact | JANELLE G. REILLY President 208-367-6490 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208000000X Pediatrics |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
207R00000X Internal Medicine | |
207V00000X Obstetrics & Gynecology | |
367A00000X Advanced Practice Midwife | |
Enumeration Date | 2006-05-12 |
Last Update Date | 2008-10-09 |