| NPI | 1841480407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN STERLING DONALDSON Owner/President 208-467-6567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: ID CHIA-661) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-10-04 |