NPI age
19 years
Enumerated 2006-12-26
Across 7 active portable x-ray and/or other portable diagnostic imaging supplier providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 8A992 | BLUE CROSS |
| 05 (ID) | 002593800 | |
| 01 (ID) | 000010008741 | REGENCE BLUE SHIELD |
Single-site organization. Only one practice location on file.
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