| NPI | 1982738662 |
|---|---|
| Doing Business As | MALAD VALLEY CLINIC |
| Entity Type | Organization |
| Authorized Contact | STEPHEN CHARLES JOHNSON Medical Director 208-766-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 0-41) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: ID 0-41) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |