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1053339457
GERALD E CARLSON
NAMPA, ID
NPI
1053339457
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: ID 0-19)
Enumeration Date
2006-07-17
Last Update Date
2007-07-08
Business Address
Mr. GERALD E CARLSON D.O
1603 12TH AVE RD STE. B
NAMPA, ID 83686-7712
Phone number: 208-467-2400
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Mailing Address
Mr. GERALD E CARLSON D.O
1603 12TH AVE RD STE. B
NAMPA, ID 83686-7712
Phone number: 208-467-2400
Copy
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