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1992490254
TONY BASTAR
MERIDIAN, ID
NPI
1992490254
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: ID 56825)
Enumeration Date
2023-04-11
Last Update Date
2023-04-12
Business Address
TONY BASTAR NP
58 W CHRISFIELD DR
MERIDIAN, ID 83646-3255
Phone number: 208-419-5300
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Mailing Address
TONY BASTAR NP
58 W CHRISFIELD DR
MERIDIAN, ID 83646-3255
Phone number: 208-419-5300
Copy
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