| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1164402681 | JOHNSON | JOHN | A. | 190 E BANNOCK ST | BOISE | ID | 83712 | |
| 1902302425 | KEELER | JESSE | DAVID | 190 E BANNOCK ST | BOISE | ID | 837126241 | |
| 1578651600 | MOLINA-MEDINA | ARMIDA | FLORES | 190 E BANNOCK ST | BOISE | ID | 837126241 | |
| 1023410990 | TITMUS | MARY | ELISABETH | 3165 E GREENHURST RD | NAMPA | ID | 836868655 | |
| 1922001478 | ZEIMANTZ | STEPHEN | J | 190 E BANNOCK ST | BOISE | ID | 837126241 |