NPI | 1891104014 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES AROET WHITAKER President 208-322-5922 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: ID O-0794) |
Enumeration Date | 2014-08-13 |
Last Update Date | 2014-08-13 |