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1720095011
MICHAEL LEE BUCKINGHAM
BOISE, ID
NPI
1720095011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: ID RNA-308)
Enumeration Date
2006-08-01
Last Update Date
2007-07-08
Business Address
-- MICHAEL LEE BUCKINGHAM CRNA
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1136
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Mailing Address
-- MICHAEL LEE BUCKINGHAM CRNA
13191 W SCOTFIELD ST
BOISE, ID 83713-0899
Phone number: 208-938-2107
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