SearchIdahoPrivate Vehicle

Anna Blackford

NPI 1114236429 · on the registry since 2010 · sole proprietor

Practice

Address
455 39 G Rd
Sagle, ID 83860
Phone
(208) 290-1079

Registry record

Primary taxonomy
Private Vehicle
347C00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2010-10-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho