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1851446561
BRYAN D HUNTSMAN
IDAHO FALLS, ID
NPI
1851446561
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: ID pt-457)
Enumeration Date
2007-01-24
Last Update Date
2010-08-04
Business Address
-- BRYAN D HUNTSMAN m.s., p.t.
2570 CHANNING WAY
IDAHO FALLS, ID 83404-7515
Phone number: 208-529-8005
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Mailing Address
-- BRYAN D HUNTSMAN m.s., p.t.
2570 CHANNING WAY
IDAHO FALLS, ID 83404-7515
Phone number: 208-529-8005
Copy
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