NPI | 1922377027 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIELLE BENNION Owner 208-853-2273 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
208D00000X General Practice | |
Enumeration Date | 2011-12-19 |
Last Update Date | 2017-04-10 |