DAVID S MICKLITZ

BOISE, ID
NPI1720099088
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA505)
Enumeration Date2006-08-11
Last Update Date2007-07-09
Business Address
Mr. DAVID S MICKLITZ CRNA
111 W STATE ST
BOISE, ID 83702-6127
Phone number: 208-336-0895
Mailing Address
Mr. DAVID S MICKLITZ CRNA
111 W STATE ST
BOISE, ID 83702-6127
Phone number: 208-336-0895
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