MARK MITCHELL ROUBIDOUX

MOSCOW, ID
NPI1629685235
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: ID  39235)
Enumeration Date2020-09-28
Last Update Date2024-07-19
Business Address
Mr. MARK MITCHELL ROUBIDOUX
803 S MAIN ST # 320
MOSCOW, ID 83843-2695
Phone number: 208-883-1008
Mailing Address
Mr. MARK MITCHELL ROUBIDOUX
201 18TH AVE
LEWISTON, ID 83501-2768
Phone number: 208-305-3537
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