| NPI | 1922287226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER STEVENSON BRUNT President 208-201-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: ID M3281) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2007-11-02 |