ALAN JAKE POULTER

IDAHO FALLS, ID
NPI1912046913
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: NM  2004-0463)
Enumeration Date2007-02-06
Last Update Date2014-10-15
Business Address
ALAN JAKE POULTER MD
2375 E SUNNYSIDE RD STE J
IDAHO FALLS, ID 83404-8280
Phone number: 208-522-7246
Mailing Address
ALAN JAKE POULTER MD
2375 E SUNNYSIDE RD STE J
IDAHO FALLS, ID 83404-8280
Phone number: 208-522-7246
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