TRAVIS DALE NIELSEN

POCATELLO, ID
NPI1730340365
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  O-0554)
Enumeration Date2008-06-17
Last Update Date2011-09-22
Business Address
-- TRAVIS DALE NIELSEN D.O.
1951 BENCH RD SUITE B
POCATELLO, ID 83201-2073
Phone number: 208-238-1000
Mailing Address
-- TRAVIS DALE NIELSEN D.O.
1951 BENCH RD SUITE B
POCATELLO, ID 83201-2073
Phone number: 208-238-1000
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