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1376701367
VICKI J LARSON
NAMPA, ID
NPI
1376701367
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
Enumeration Date
2008-05-28
Last Update Date
2008-05-28
Business Address
Ms. VICKI J LARSON
2914 E POWERLINE RD
NAMPA, ID 83687-4920
Phone number: 208-353-0329
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Mailing Address
Ms. VICKI J LARSON
2914 E POWERLINE RD
NAMPA, ID 83687-4920
Phone number: 208-353-0329
Copy
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