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1447708177
BIRDEE LYNNE DAVIS
POCATELLO, ID
NPI
1447708177
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
(Licence: ID PTA-2547)
Enumeration Date
2016-09-11
Last Update Date
2016-09-11
Business Address
-- BIRDEE LYNNE DAVIS PTA
715 CHERRY ST
POCATELLO, ID 83201-5646
Phone number: 208-705-4999
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Mailing Address
-- BIRDEE LYNNE DAVIS PTA
715 CHERRY ST
POCATELLO, ID 83201-5646
Phone number: 208-705-4999
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