BLACK CANYON MEDICAL GROUP PLLC
Family Medicine
Active
Organization
NPI: 1811419708
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Family Medicine | 207Q00000X | Yes | M9309 (ID) |
Frequently Asked Questions
NPI 1811419708 is the National Provider Identifier for BLACK CANYON MEDICAL GROUP PLLC, a Family Medicine provider located in Emmett, ID. This NPI was enumerated on July 12, 2017.
Quick Facts
- NPI
- 1811419708
- Type
- Organization
- Enumerated
- Jul 12, 2017
- Last Updated
- Jul 21, 2022
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LATISHA BOWMAN, LPC
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MERRIT AUNE, RPH
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