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1255567210
HYRUM DAVENPORT
BLACKFOOT, ID
NPI
1255567210
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID N-36016)
Enumeration Date
2009-06-04
Last Update Date
2009-06-04
Business Address
HYRUM DAVENPORT NP
1441 PARKWAY DR
BLACKFOOT, ID 83221-1667
Phone number: 208-785-2600
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Mailing Address
HYRUM DAVENPORT NP
1441 PARKWAY DR
BLACKFOOT, ID 83221-1667
Phone number: 208-785-2600
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