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Marc Anderson
NPI 1316314842 · on the registry since 2015
Practice
- Address
- 150 N State St
Rigby, ID 83442 - Phone
- (208) 745-0267
- Organisation at this address
- Broulim Supermarkets, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-09-01
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