| NPI | 1699141150 |
|---|---|
| Doing Business As | PAIN AND SPINE SPECIALISTS OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | NED HILLYARD Chief Compliance Officer 208-557-2711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-09-23 |