| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1285127464 | BATEMAN | MARA | ROSE | 190 E BANNOCK ST | BOISE | ID | 837126241 | |
| 1326140039 | BUCUR | SILVANA | Z | 190 E BANNOCK ST | BOISE | ID | 837126241 | |
| 1124510656 | MILLER | DEREK | ALAN | 2807 E MASSACHUSETTS AVE | NAMPA | ID | 836866723 | |
| 1174072243 | PARTIN | M. RYAN | 190 E BANNOCK ST | BOISE | ID | 837126241 | ||
| 1043461817 | WILLIAMS | TRAVIS | G | 190 E BANNOCK ST | BOISE | ID | 837126241 |