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1740605740
JOANNA BORK
BOISE, ID
NPI
1740605740
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133VN1004X Dietitian, Registered, Nutrition, Pediatric
(Licence: ID D-288)
Enumeration Date
2014-02-27
Last Update Date
2014-02-27
Business Address
-- JOANNA BORK
100 E IDAHO ST SUITE 200
BOISE, ID 83712-6267
Phone number: 208-381-7081
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Mailing Address
-- JOANNA BORK
624 N GLEN ASPEN WAY
STAR, ID 83669-5755
Phone number: 208-484-2523
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