NPI age
6 years
Enumerated 2019-07-22
Across 326 active clinic/center providers in Idaho.
1 secondary location on file with NPPES.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1740604529 | TYPE I NPI |
Multi-provider organization. 2 individual providers on file at this primary address. Plus 1 secondary practice location.
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