DAVID ONTIVEROS

BURLEY, ID
NPI1992873327
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  O210)
Enumeration Date2006-12-01
Last Update Date2007-07-08
Business Address
-- DAVID ONTIVEROS DO
1501 HILAND AVE
BURLEY, ID 83318-2682
Phone number: 208-677-6428
Mailing Address
-- DAVID ONTIVEROS DO
1501 HILAND AVE
BURLEY, ID 83318-2682
Phone number: 208-677-6428
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