NPI age
20 years
Enumerated 2005-06-09
Across 67 active podiatrist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002667000 | |
| 01 (ID) | 480009676 | PALMETTO GBA |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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