| NPI | 1972627628 |
|---|---|
| Doing Business As | ST LUKES DEVELOPMENTAL PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | JERRY HIRSCHFELD Administrator 208-381-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: ID 03) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |