| NPI | 1790983385 |
|---|---|
| Other Name | SLIM MIDLEVEL PROVIDERS |
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNNE COWGILL Credentialing Coordinator 208-381-4137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |