NPI age
16 years
Enumerated 2009-10-16
Across 99 active clinic/center providers in Idaho.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1871902 | MEDICARE PTAN |
Multi-provider organization. 20 individual providers on file at this primary address.
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