| NPI | 1962545681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE DENNY Clinic Manager 208-227-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2015-03-06 |