DANIEL VINCENT

CALDWELL, ID
NPI1760173405
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: ID  PTA-7438)
Enumeration Date2023-05-15
Last Update Date2023-05-15
Business Address
DANIEL VINCENT PTA
4623 ENTERPRISE WAY
CALDWELL, ID 83605-6764
Phone number: 208-455-4231
Mailing Address
DANIEL VINCENT PTA
1141 E FAIRVIEW AVE APT M201
MERIDIAN, ID 83642-1837
Phone number: 515-249-8881