NPI age
7 years
Enumerated 2019-04-30
Across 9 active family medicine providers in Idaho.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | M-6006 | MEDICAL LICENCE |
| 01 (ID) | LMSW-34242 | SOCIAL WORK LICENSE |
Multi-provider organization. 4 individual providers on file at this primary address.
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