CLAY CORNELISON

BOISE, ID
NPI1609454040
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-03-29
Last Update Date2021-03-29
Business Address
CLAY CORNELISON DO
500 W FORT ST BLDG 116
BOISE, ID 83702-4501
Phone number: 208-422-1165
Mailing Address
CLAY CORNELISON DO
500 W FORT ST BLDG 116
BOISE, ID 83702-4501
Phone number: 208-422-1165