MARK WILLIS

POCATELLO, ID
NPI1154838886
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: ID  57490)
Enumeration Date2018-01-03
Last Update Date2021-05-18
Business Address
MARK WILLIS FNP
1350 CEDAR LAKE RD
POCATELLO, ID 83204-4946
Phone number: 208-705-2575
Mailing Address
MARK WILLIS FNP
1350 CEDAR LAKE RD
POCATELLO, ID 83204-4946
Phone number: 208-705-2575