DNA WITH TINA LLC

POCATELLO, ID
NPI1306105598
Entity TypeOrganization
Authorized ContactCHRISTINE FUHRMAN MLADENKA
Owner
208-240-4785
Organization Subpart ?No
Primary Taxonomy363LW0102X Nurse Practitioner, Women's Health
Enumeration Date2012-05-09
Last Update Date2012-09-25
Business Address
DNA WITH TINA LLC
1951 BENCH RD
POCATELLO, ID 83201-2073
Phone number: 208-240-4785
Mailing Address
DNA WITH TINA LLC
1951 BENCH RD
POCATELLO, ID 83201-2073
Phone number: 208-240-4785
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