NICHOLAS LONGE

POCATELLO, ID
NPI1740020148
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  MRO-2428)
Enumeration Date2024-05-31
Last Update Date2024-06-26
Business Address
NICHOLAS LONGE DO
465 MEMORIAL DR
POCATELLO, ID 83201-4008
Phone number: 208-232-7862
Mailing Address
NICHOLAS LONGE DO
500 S 11TH AVE STE 400
POCATELLO, ID 83201-4880
Phone number: 208-232-7862
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