| NPI | 1952377459 |
|---|---|
| Doing Business As | POCATELLO RADIOLOGY PHYSICIANS OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | STEVEN A. LARSEN President 208-233-1187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2014-08-04 |