| NPI | 1952518946 |
|---|---|
| Doing Business As | SHOSHONE BANNOCK CLINIC PODIATRY GROUP |
| Entity Type | Organization |
| Authorized Contact | ANGELA MENDEZ Tribal Health Director 208-478-3994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |