NPI | 1689621294 |
---|---|
Doing Business As | FAMILY CARE CLINIC OF IDAHO FALLS |
Entity Type | Organization |
Authorized Contact | BRIAN JOSEPH DECKER Partner 208-523-3436 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID NP616A) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2020-08-22 |