| NPI | 1952782914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET M HOOVER Billing Manager 208-528-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ID D-841) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |