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1124504337
BREANNA CARLOS
POCATELLO, ID
NPI
1124504337
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2018-07-11
Last Update Date
2018-07-11
Business Address
BREANNA CARLOS
1169 CALL CREEK DR
POCATELLO, ID 83201-3077
Phone number: 202-232-7780
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Mailing Address
BREANNA CARLOS
1169 CALL CREEK DR
POCATELLO, ID 83201-3077
Phone number: 208-232-7780
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