JORDAN THOMAS TAIT

BOISE, ID
NPI1750863205
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  59764)
Enumeration Date2018-08-31
Last Update Date2019-05-01
Business Address
JORDAN THOMAS TAIT CRNA
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
Mailing Address
JORDAN THOMAS TAIT CRNA
2537 W STATE ST STE 200
BOISE, ID 83702-2200
Phone number: 208-336-0895
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