| NPI | 1962944272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA JAMESON Md / Owner 208-457-4208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208600000X Surgery | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2017-04-14 |