NPI | 1942227699 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID L SCHLACTUS CEO 208-298-3100 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: ID 04-206454) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2016-12-12 |