TIMOTHY A POWELL

BOISE, ID
NPI1972617363
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: ID  RNA-579)
Enumeration Date2006-08-19
Last Update Date2007-07-09
Business Address
Mr. TIMOTHY A POWELL
111 W STATE ST
BOISE, ID 83702-6127
Phone number: 208-336-0895
Mailing Address
Mr. TIMOTHY A POWELL
111 W STATE ST
BOISE, ID 83702-6127
Phone number: