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1225330954
NICHOLAS STODDARD
POCATELLO, ID
NPI
1225330954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: ID RNA-821A)
Enumeration Date
2010-12-01
Last Update Date
2012-02-13
Business Address
NICHOLAS STODDARD CRNA
777 HOSPITAL WAY
POCATELLO, ID 83201-5175
Phone number: 208-232-7760
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Mailing Address
NICHOLAS STODDARD CRNA
PO BOX 4107
POCATELLO, ID 83205-4107
Phone number: 208-232-7760
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