NPI | 1750920401 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA LAPLANTE Owner 208-635-5265 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2019-12-29 |
Last Update Date | 2024-07-01 |