JUSTIN GREGORY MERZLOCK

CHUBBUCK, ID
NPI1013668847
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: ID  71322)
Enumeration Date2022-01-13
Last Update Date2022-01-13
Business Address
-- JUSTIN GREGORY MERZLOCK FNP
4511 ZEBE AVE
CHUBBUCK, ID 83202-4707
Phone number: 208-904-4780
Mailing Address
-- JUSTIN GREGORY MERZLOCK FNP
14926 W BRANDY LN
POCATELLO, ID 83202-5345
Phone number: 208-251-5027