RAPHAEL SHAKUR KOMAKECH

BOISE, ID
NPI1770223562
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-03-30
Last Update Date2022-03-30
Business Address
RAPHAEL SHAKUR KOMAKECH MBBChB
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
Mailing Address
RAPHAEL SHAKUR KOMAKECH MBBChB
500 W FORT ST # 111R
BOISE, ID 83702-4501
Phone number: 208-422-1314
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