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1104055367
JOSHUA J MACKIE
BOISE, ID
NPI
1104055367
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: ID RNA755)
Enumeration Date
2009-07-09
Last Update Date
2009-07-09
Business Address
-- JOSHUA J MACKIE CRNA
338 E BANNOCK ST
BOISE, ID 83712-6207
Phone number: 208-336-0895
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Mailing Address
-- JOSHUA J MACKIE CRNA
338 E BANNOCK ST
BOISE, ID 83712-6207
Phone number: 208-336-0895
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