MARK E KIECKBUSCH

BOISE, ID
NPI1215981410
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: ID  M6070)
Additional Taxonomies207ZH0000X Pathology, Hematology
(Licence: ID  M6070)
Enumeration Date2006-05-20
Last Update Date2007-12-11
Business Address
-- MARK E KIECKBUSCH M.D.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2367
Mailing Address
-- MARK E KIECKBUSCH M.D.
PO BOX 9589
BOISE, ID 83707-4589
Phone number: 208-472-8104