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1881055705
ISMAEL GRACHICO
TWIN FALLS, ID
NPI
1881055705
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: ID M-16804)
Additional Taxonomies
208600000X Surgery
(Licence: OR MD250761)
Enumeration Date
2016-03-20
Last Update Date
2022-10-31
Business Address
Mr. ISMAEL GRACHICO MD
775 POLE LINE RD W STE 212
TWIN FALLS, ID 83301-5820
Phone number: 208-814-8400
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Mailing Address
Mr. ISMAEL GRACHICO MD
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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