KASSIE L DODGE

BOISE, ID
NPI1275095804
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: ID  D-1265)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: WA  DI60938283)
Enumeration Date2019-04-02
Last Update Date2022-09-12
Business Address
KASSIE L DODGE RD
305 E JEFFERSON ST
BOISE, ID 83712-6231
Phone number: 208-381-7340
Mailing Address
KASSIE L DODGE RD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: