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1245690544
OLDE TOWN MEDICAL
MERIDIAN, ID
NPI
1245690544
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Entity Type
Organization
Authorized Contact
SUSAN E TOMEY
Provider/Owner
208-888-5422
Organization Subpart ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
Enumeration Date
2016-02-29
Last Update Date
2016-03-11
Business Address
OLDE TOWN MEDICAL
124 E PINE AVE
MERIDIAN, ID 83642-2331
Phone number: 208-887-5422
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Mailing Address
OLDE TOWN MEDICAL
124 E PINE AVE
MERIDIAN, ID 83642-2331
Phone number: 208-887-5422
Copy
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