| NPI | 1922205608 |
|---|---|
| Doing Business As | MOUNTAIN RIVER MEDICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | LISA RUDOLPH Pso Support Specialist 208-782-3992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207V00000X Obstetrics & Gynecology | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2009-02-18 |