NPI age
13 years
Enumerated 2013-05-16
Across 326 active clinic/center providers in Idaho.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1265565477 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 2 individual providers on file at this primary address.
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