| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1205164126 | BALLANCE | PHILIP | ANDERS | 915 W EMMA AVE | COEUR D ALENE | ID | 838142531 | |
| 1265000988 | CLINE | DARYL | SCOTT | 915 W EMMA AVE | COEUR D ALENE | ID | 838142531 | |
| 1770029068 | MOORE | SHEENA | 915 W EMMA AVE | COEUR D ALENE | ID | 838142531 |