NPI age
19 years
Enumerated 2006-10-06
Across 6 active neuromusculoskeletal medicine, sports medicine providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010140195 | REGENCE BLUE SHIELD |
| 01 (ID) | 204221200 | US DEPT OF LABOR |
| 01 (ID) | 8H989 | BLUE CROSS |
| 01 (ID) | DA4495 | RAILROAD MEDICARE |
| 05 (ID) | 806811100 |
Multi-provider organization. 1 individual provider on file at this primary address.
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