| NPI | 1831730118 |
|---|---|
| Doing Business As | IDAHO SKIN CENTER |
| Entity Type | Organization |
| Authorized Contact | ANTHONY RIETH Managing Member 208-716-4741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2020-11-29 |