Graduated: 2016
NPI: 1447612940
Practice Locations (3)
SENIOR DOC IDAHO PC
595 CHAPEL HILLS DR, SUITE 303A
COLORADO SPRINGS, CO 809201022
7144753293
SENIOR DOC IDAHO PC
4301 GARRITY BLVD, SUITE 103
NAMPA, ID 836879222
8554347763
SENIOR DOC IDAHO PC
MARYSVILLE, WA 98270
8554347763
Source: CMS National Downloadable File, September 2026.