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1649372418
STACIE L WAITE
NAMPA, ID
NPI
1649372418
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: ID PT-2073)
Enumeration Date
2006-09-02
Last Update Date
2007-07-08
Business Address
MS. STACIE L WAITE PT
337 W IOWA AVE
NAMPA, ID 83686-2856
Phone number: 208-467-7889
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Mailing Address
MS. STACIE L WAITE PT
337 W IOWA AVE
NAMPA, ID 83686-2856
Phone number: 208-467-7889
Copy
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