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1164596128
ANGHARAD SUPE LYON
POCATELLO, ID
NPI
1164596128
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: ID PA-365)
Enumeration Date
2006-11-20
Last Update Date
2007-07-08
Business Address
Miss ANGHARAD SUPE LYON PA-C
ISU STUDENT HEALTH CTR 921 S. 8TH ST.
POCATELLO, ID 83209-0001
Phone number: 208-282-2330
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Mailing Address
Miss ANGHARAD SUPE LYON PA-C
69 FOOTHILL BLVD
POCATELLO, ID 83204-4063
Phone number: 208-282-2330
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