THIAGO ALBERTO

BOISE, ID
NPI1023650512
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: ID  62877)
Enumeration Date2019-10-16
Last Update Date2021-07-13
Business Address
THIAGO ALBERTO NP
11197 W FAIRVIEW AVE
BOISE, ID 83713-7935
Phone number: 208-378-8011
Mailing Address
THIAGO ALBERTO NP
PO BOX 191050
BOISE, ID 83719-1050
Phone number: 208-955-6500
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