WALTER O LOUGH

BOISE, ID
NPI1881324945
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: ID  10822)
Enumeration Date2022-06-13
Last Update Date2022-06-13
Business Address
WALTER O LOUGH LPN, CWCA
500 W FORT ST
BOISE, ID 83702-4599
Phone number: 208-504-8354
Mailing Address
WALTER O LOUGH LPN, CWCA
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-504-8354