| Organization Name: | FAMILY MEDICAL CARE PLLC |
| NPI Number: | 1053615427 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN LAWRENCE TORQUATO (PRESIDENT) |
| Mailing Address: | 265 W Prairie Shopping Ctr Hayden |
| State: | ID US |
| Postal Code: | 838359855 |
| Phone Number: | 2087727850 |
| Fax Number: | 2087722313 |
| NPI Enumeration Date: | 12/29/2010 |
| NPI Last Update Date: | 12/29/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PAG-019 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |