| NPI | 1942385968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C. HILL Manager 208-684-5537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: ID M-4478) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |