| NPI | 1669676276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S JEFF BRAY President 208-233-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P157) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-09-07 |