| NPI | 1881734135 |
|---|---|
| Doing Business As | VICTOR MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | LAURA C PIQUET Operations Manager 208-354-6302 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 31) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID 31) |
| 208000000X Pediatrics (Licence: ID 31) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: ID 31) | |
| 208600000X Surgery (Licence: ID 31) | |
| 208800000X Urology (Licence: ID 31) | |
| 1041C0700X Social Worker, Clinical (Licence: ID 31) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2010-11-18 |