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1609454040
CLAY CORNELISON
BOISE, ID
NPI
1609454040
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-03-29
Last Update Date
2021-03-29
Business Address
CLAY CORNELISON DO
500 W FORT ST BLDG 116
BOISE, ID 83702-4501
Phone number: 208-422-1165
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Mailing Address
CLAY CORNELISON DO
500 W FORT ST BLDG 116
BOISE, ID 83702-4501
Phone number: 208-422-1165
Copy
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