| NPI | 1710975057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN OLOF DAHLIN Owner 208-452-2510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-6608) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD13079) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-08-22 |