| NPI | 1770961559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HASSINGER Manager 208-321-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |