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1730254285
JAY T THIEMANN
MOSCOW, ID
NPI
1730254285
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
246ZS0410X Specialist/Technologist, Other Surgical Technologist
(Licence: WA ST00002460)
Enumeration Date
2006-11-21
Last Update Date
2007-07-08
Business Address
JAY T THIEMANN ST
623 S MAIN ST SUITE 6
MOSCOW, ID 83843-2983
Phone number: 208-883-2828
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Mailing Address
JAY T THIEMANN ST
623 S MAIN ST SUITE 6
MOSCOW, ID 83843-2983
Phone number: 208-883-2828
Copy
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