JEFFERY THOMAS LY

CALDWELL, ID
NPI1194229310
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: ID  46147)
Enumeration Date2018-03-21
Last Update Date2018-03-21
Business Address
Mr. JEFFERY THOMAS LY RN
11961 PHEASANT RUN ST
CALDWELL, ID 83605-5082
Phone number: 208-590-8166
Mailing Address
Mr. JEFFERY THOMAS LY RN
11961 PHEASANT RUN ST
CALDWELL, ID 83605-5082
Phone number: 208-590-8166
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