| NPI | 1699150623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN T STORY M.D. 208-343-1702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID M12140) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2019-07-19 |