SearchIdaho261QP3300X

Matt Wrathall, CM

NPI 1205612405 · on the registry since 2023 · sole proprietor

Practice

Address
663 Trejo St
Rexburg, ID 83440
Phone
(385) 758-4356

Registry record

Primary taxonomy
261QP3300X
261QP3300X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-03-16

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