| NPI | 1982870564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL DAVIS President 208-233-8035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: ID 261QH0100X) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |