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1134965197
RUSTY JAMES WATTIER
CALDWELL, ID
NPI
1134965197
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-07-08
Last Update Date
2024-07-08
Business Address
Mr. RUSTY JAMES WATTIER SUDA
709 DEARBORN ST
CALDWELL, ID 83605-4116
Phone number: 208-606-9494
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Mailing Address
Mr. RUSTY JAMES WATTIER SUDA
709 DEARBORN ST
CALDWELL, ID 83605-4116
Phone number: 208-606-9494
Copy
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