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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