| NPI | 1891733747 |
|---|---|
| Doing Business As | KOOSKIA MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | LARRY BARKER COO 208-476-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2008-04-22 |