GUSTIN ROSS BLAD

POCATELLO, ID
NPI1982979936
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: ID  NP-1143A)
Enumeration Date2012-03-08
Last Update Date2012-03-08
Business Address
MR. GUSTIN ROSS BLAD FNP-BC
777 HOSPITAL WAY
POCATELLO, ID 83201-5175
Phone number: 208-239-1000
Mailing Address
MR. GUSTIN ROSS BLAD FNP-BC
777 HOSPITAL WAY
POCATELLO, ID 83201-5175
Phone number: 208-239-1000
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