PAVEL L ZAVERUKHA

MERIDIAN, ID
NPI1124561063
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
(Licence: ID  OTA-1036)
Enumeration Date2016-11-26
Last Update Date2016-11-26
Business Address
PAVEL L ZAVERUKHA
4933 W ASTONTE ST
MERIDIAN, ID 83646-7101
Phone number: 208-392-8056
Mailing Address
PAVEL L ZAVERUKHA
4933 W ASTONTE ST
MERIDIAN, ID 83646-7101
Phone number: 208-392-8056
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