NPI age
20 years
Enumerated 2006-05-19
Across 46 active clinic/center providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807612400 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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