| NPI | 1891834768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE A CHATFIELD Billing Supervisor 208-667-0621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: ID M-3632) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-07-17 |