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1538802830
KATHLEEN L LACASSE
MOUNTIAN HOME AFB, ID
NPI
1538802830
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2022-04-15
Last Update Date
2023-06-26
Business Address
Miss KATHLEEN L LACASSE IDMT
90 HOPE DRIVE BLDG 6000
MOUNTIAN HOME AFB, ID 83648
Phone number: 208-828-7401
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Mailing Address
Miss KATHLEEN L LACASSE IDMT
90 HOPE DRIVE BLDG 6000
MOUNTIAN HOME AFB, ID 83648
Phone number: 860-921-6527
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