| NPI | 1689082182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA K HONG President 208-521-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: ID OT-849) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |