| NPI | 1679621098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL D BENNETT CEO 208-267-4850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ID 43) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID 43) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ID 43) | |
| 207X00000X Orthopaedic Surgery (Licence: ID 43) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID 43) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-06-28 |