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1881459543
REAGAN E FERNLEY
HOMEDALE, ID
NPI
1881459543
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine
(Licence: ID 8554)
Enumeration Date
2024-02-20
Last Update Date
2024-02-20
Business Address
REAGAN E FERNLEY PTA
134 E IDAHO AVE
HOMEDALE, ID 83628-5003
Phone number: 208-337-3254
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Mailing Address
REAGAN E FERNLEY PTA
1217 S BENEWAH ST
NAMPA, ID 83686-2868
Phone number: 651-788-0664
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