| NPI | 1861589236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARCY SUE TAYLOR Office Manager 208-263-8597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2010-12-28 |