MARA ADDITON

POCATELLO, ID
NPI1184067613
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: ID  M-14265)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2013-04-15
Last Update Date2018-09-13
Business Address
MARA ADDITON M.D.
777 HOSPITAL WAY STE 201
POCATELLO, ID 83201-5175
Phone number: 208-239-2620
Mailing Address
MARA ADDITON M.D.
PO BOX 4168
POCATELLO, ID 83205-4168
Phone number: 208-239-2065