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1053314864
ALVIN JACKSON SECREST
COTTONWOOD, ID
NPI
1053314864
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID M6256)
Enumeration Date
2005-05-24
Last Update Date
2021-08-11
Business Address
ALVIN JACKSON SECREST MD
701 LEWISTON ST
COTTONWOOD, ID 83522-9750
Phone number: 208-962-3267
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Mailing Address
ALVIN JACKSON SECREST MD
PO BOX 565
COTTONWOOD, ID 83522-0565
Phone number: 208-962-3267
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