Graduated: 2013
NPI: 1114339769
Practice Locations (4)
13814 W 2ND AVE
Orofino, ID 835449109
13814 W 2ND AVE
OROFINO, ID 835449109
416 JOHNSON AVE
OROFINO, ID 835448501
2085020894
416 JOHNSON AVE
OROFINO, ID 835449516
Source: CMS National Downloadable File, September 2026.