STATE OF IDAHO

NAMPA, ID
NPI1588780449
Entity TypeOrganization
Authorized ContactSUE BROETJE
Administrative Director
208-442-2812
Organization Subpart ?No
Primary Taxonomy213E00000X Podiatrist
Enumeration Date2007-03-22
Last Update Date2020-08-22
Business Address
STATE OF IDAHO
1660 11TH AVE N
NAMPA, ID 83687-5000
Phone number: 208-442-2812
Mailing Address
STATE OF IDAHO
1660 11TH AVE N
NAMPA, ID 83687-5000
Phone number: 208-442-2812
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