NPI age
19 years
Enumerated 2006-07-21
Across 120 active clinic/center providers in Idaho.
1 secondary location on file with NPPES.
11 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1134149941 | |
| 01 (ID) | 185406300 | OWCP |
| 01 (ID) | T9107 | BLUE CROSS OF IDAHO |
| 01 (ID) | 350075001 | GROUP HEALTH |
| 01 (ID) | 000010026849 | REGENCE BLUE SHIELD |
Multi-provider organization. 11 individual providers on file at this primary address. Plus 1 secondary practice location.
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