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1750074563
LIAM ANDREW WICKENBURG
POCATELLO, ID
NPI
1750074563
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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
2023-05-29
Last Update Date
2023-05-29
Business Address
MR. LIAM ANDREW WICKENBURG
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209-0002
Phone number: 208-282-4726
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Mailing Address
MR. LIAM ANDREW WICKENBURG
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209-0002
Phone number: 208-282-4726
Copy
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