| NPI | 1700974714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS BLATY Owner 208-667-1376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: ID M6482) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2022-06-01 |