JOANNA BORK

BOISE, ID
NPI1740605740
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: ID  D-288)
Enumeration Date2014-02-27
Last Update Date2014-02-27
Business Address
-- JOANNA BORK
100 E IDAHO ST SUITE 200
BOISE, ID 83712-6267
Phone number: 208-381-7081
Mailing Address
-- JOANNA BORK
624 N GLEN ASPEN WAY
STAR, ID 83669-5755
Phone number: 208-484-2523
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