NPI age
20 years
Enumerated 2006-05-19
Across 5 active neuromusculoskeletal medicine & omm providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 805192200 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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