ANGHARAD SUPE LYON

POCATELLO, ID
NPI1164596128
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: ID  PA-365)
Enumeration Date2006-11-20
Last Update Date2007-07-08
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
Mailing Address
MISS ANGHARAD SUPE LYON PA-C
69 FOOTHILL BLVD
POCATELLO, ID 83204-4063
Phone number: 208-282-2330
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