| NPI | 1992325815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MICHAEL KOLOBOW Business Owner & Nurse Practioner 208-267-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |