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1063256584
REATTA OMOTH
TWIN FALLS, ID
NPI
1063256584
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: ID 9861160)
Enumeration Date
2024-06-20
Last Update Date
2024-09-09
Business Address
REATTA OMOTH FNP-C
2550 ADDISON AVE E STE E
TWIN FALLS, ID 83301-6748
Phone number: 208-814-7780
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Mailing Address
REATTA OMOTH FNP-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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