NPI age
6 years
Enumerated 2019-11-04
Across 61 active clinic/center providers in Idaho.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 13D2157719 | CLIA |
Multi-provider organization. 4 individual providers on file at this primary address.
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