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1730884693
KEENAN BAPTISTA
BOISE, ID
NPI
1730884693
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-31
Last Update Date
2024-07-11
Business Address
KEENAN BAPTISTA DO
500 W FORT ST BLDG 116
BOISE, ID 83702-4501
Phone number: 208-422-1165
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Mailing Address
KEENAN BAPTISTA DO
500 W FORT ST BLDG 116
BOISE, ID 83702-4501
Phone number: 208-422-1165
Copy
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