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1720099088
DAVID S MICKLITZ
BOISE, ID
NPI
1720099088
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: ID RNA505)
Enumeration Date
2006-08-11
Last Update Date
2007-07-09
Business Address
Mr. DAVID S MICKLITZ CRNA
111 W STATE ST
BOISE, ID 83702-6127
Phone number: 208-336-0895
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Mailing Address
Mr. DAVID S MICKLITZ CRNA
111 W STATE ST
BOISE, ID 83702-6127
Phone number: 208-336-0895
Copy
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