NPI age
3 years
Enumerated 2022-10-14
Across 326 active specialist/technologist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | AT-840 | IDAHO BOARD OF MEDICINE |
| 01 (ID) | 2000051191 | NATA BOARD OF CERTIFICATION |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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