| NPI | 1780103507 |
|---|---|
| Other Name | AMBULATORY SURGERY CENTER OF BURLEY ANESTHESIA |
| Entity Type | Organization |
| Authorized Contact | JOSEPH R PETERSEN CEO 208-677-8888 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |