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1720863871
LEVI GRAVES
POCATELLO, ID
NPI
1720863871
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ID 77238)
Enumeration Date
2023-08-28
Last Update Date
2023-08-28
Business Address
LEVI GRAVES
415 N 3RD AVE STE B
POCATELLO, ID 83201-6306
Phone number: 208-646-4165
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Mailing Address
LEVI GRAVES
226 W CARTER ST
POCATELLO, ID 83204-3454
Phone number: 208-252-5451
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