BEAU S. DANIEL

POCATELLO, ID
NPI1760712327
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA-936A)
Enumeration Date2010-01-05
Last Update Date2019-08-14
Business Address
Mr. BEAU S. DANIEL CRNA
285 VISTA DR
POCATELLO, ID 83201-4987
Phone number: 208-478-1704
Mailing Address
Mr. BEAU S. DANIEL CRNA
PO BOX 3750
SALT LAKE CITY, UT 84110-3750
Phone number: 800-880-3566
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