LUKE ADAM POULTER

POCATELLO, ID
NPI1700290947
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  MRO-1384)
Enumeration Date2014-06-16
Last Update Date2014-06-16
Business Address
-- LUKE ADAM POULTER D.O.
465 MEMORIAL DR
POCATELLO, ID 83201-4008
Phone number: 208-282-4700
Mailing Address
-- LUKE ADAM POULTER D.O.
465 MEMORIAL DR
POCATELLO, ID 83201-4008
Phone number: 208-282-4700
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