NPI age
15 years
Enumerated 2010-07-14
Across 67 active podiatrist providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (MO) | 1407169865 | |
| 01 (MO) | P01271994 | RAILROAD MEDICARE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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