DEREK SHAUNE GRANTHAM

POCATELLO, ID
NPI1487485546
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-08-12
Last Update Date2026-09-16
Business Address
Mr. DEREK SHAUNE GRANTHAM
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209-0002
Phone number: 208-282-4726
Mailing Address
Mr. DEREK SHAUNE GRANTHAM
1689 W SHORELINE DR APT 225
BOISE, ID 83702-6761
Phone number: 231-846-7247
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