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1205842358
BRENT MICHAEL SUTHERLAND
IDAHO FALLS, ID
NPI
1205842358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: ID C146478)
Enumeration Date
2006-07-31
Last Update Date
2007-07-08
Business Address
BRENT MICHAEL SUTHERLAND CRNA
2532 CORONADO
IDAHO FALLS, ID 83404
Phone number: 208-557-2700
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Mailing Address
BRENT MICHAEL SUTHERLAND CRNA
PO BOX 210
ROY, UT 84067-0210
Phone number: 801-825-4700
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