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1902033608
BRAD L WYNN
RUPERT, ID
NPI
1902033608
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID O-0676)
Enumeration Date
2009-06-19
Last Update Date
2023-08-25
Business Address
DR. BRAD L WYNN D.O.
1308 8TH ST STE 1
RUPERT, ID 83350-1535
Phone number: 208-436-4322
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Mailing Address
DR. BRAD L WYNN D.O.
1224 8TH STREET
RUPERT, ID 83350-1527
Phone number: 208-434-4236
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