SAMANTHA ALIX MITRO

MERIDIAN, ID
NPI1528728318
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: ID  D-1336)
Additional Taxonomies133V00000X Dietitian, Registered
Enumeration Date2021-12-21
Last Update Date2023-11-29
Business Address
SAMANTHA ALIX MITRO
520 S EAGLE RD STE 1223
MERIDIAN, ID 83642-6355
Phone number: 208-706-5260
Mailing Address
SAMANTHA ALIX MITRO
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: