TYRAY M PETTY

BOISE, ID
NPI1891555025
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2024-03-22
Last Update Date2024-03-22
Business Address
TYRAY M PETTY
6305 W OVERLAND RD
BOISE, ID 83709-3029
Phone number: 208-605-3663
Mailing Address
TYRAY M PETTY
6305 W OVERLAND RD
BOISE, ID 83709-3029
Phone number: 208-605-3663