| NPI | 1841444015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L. TORQUATO Contract Physician 208-772-7850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: ID C158693 INC.STATEID) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |