| NPI | 1982711578 |
|---|---|
| Doing Business As | PODIATRY CENTER OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | GARY J MILLWARD Administrator 208-938-4670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-12-11 |