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1801114855
ANNA LONG
IDAHO FALLS, ID
NPI
1801114855
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: ID D-325)
Enumeration Date
2010-05-13
Last Update Date
2010-05-13
Business Address
Mrs. ANNA LONG RD, LD
4150 SILVERADO DR
IDAHO FALLS, ID 83404-7788
Phone number: 208-589-3271
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Mailing Address
Mrs. ANNA LONG RD, LD
4150 SILVERADO DR
IDAHO FALLS, ID 83404-7788
Phone number: 208-589-3271
Copy
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