| NPI | 1811138910 |
|---|---|
| Doing Business As | BEAR LAKE FAMILY CARE AND OB/GYN |
| Entity Type | Organization |
| Authorized Contact | JILL RASMUSSEN PFS Assisstant 208-847-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2016-10-17 |