SearchIdaho347C00000X

Edie Lustig

NPI 1164988663 · on the registry since 2019 · sole proprietor

Practice

Address
711 N State St
Grangeville, ID 83530
Phone
(208) 507-2160

Registry record

Primary taxonomy
347C00000X
347C00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2019-02-20

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