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1396509311
MATTHEW AARON DOUGLASS
REXBURG, ID
NPI
1396509311
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ID CNP-78862)
Enumeration Date
2024-02-09
Last Update Date
2024-08-29
Business Address
MATTHEW AARON DOUGLASS PMHNP
393 E 2ND N
REXBURG, ID 83440-1605
Phone number: 208-359-4840
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Mailing Address
MATTHEW AARON DOUGLASS PMHNP
393 E 2ND N
REXBURG, ID 83440-1605
Phone number: 208-359-4840
Copy
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