CODY WADE GARDNER

BOISE, ID
NPI1376873430
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA 768)
Enumeration Date2010-01-12
Last Update Date2010-03-03
Business Address
-- CODY WADE GARDNER
1055 N CURTIS RD
BOISE, ID 83706-1309
Phone number: 208-367-6416
Mailing Address
-- CODY WADE GARDNER
PO BOX 4008
PORTLAND, OR 97208-4008
Phone number: 503-372-2740
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