| NPI | 1801197082 |
|---|---|
| Doing Business As | ST LUKE'S CLINIC - IDAHO PEDIATRIC GASTROENTEROLOGY |
| Entity Type | Organization |
| Authorized Contact | JEFF TAYLOR System VP CFO 208-381-2520 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: ID 03) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |