| NPI | 1912481292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W SCOTT RUDEEN Owner 208-733-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2022-02-07 |