| NPI | 1972745594 |
|---|---|
| Doing Business As | IDAHO SKIN INSTITUTE, INC. |
| Entity Type | Organization |
| Authorized Contact | EARL R STODDARD Owner/Physician 208-238-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID M9280) |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2012-04-04 |