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1700365178
ADAM GAULT
POCATELLO, ID
NPI
1700365178
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: ID 59581)
Enumeration Date
2018-08-07
Last Update Date
2018-11-21
Business Address
Dr. ADAM GAULT DNP, FNP-c
500 S 11TH AVE
POCATELLO, ID 83201-4835
Phone number: 208-232-6214
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Mailing Address
Dr. ADAM GAULT DNP, FNP-c
500 S 11TH AVE
POCATELLO, ID 83201-4835
Phone number: 208-232-6214
Copy
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