Stanley Wacholz, BS BIS

NPI 1548811904 · on the registry since 2019 · sole proprietor

Practice

Address: 5723 E Dodd Rd
Hayden Lake, ID 83835
Phone: (208) 651-8985
Organisation at this address: K2 Fmily Partnership
Katherine Wacholz Agency
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 106E00000X
106E00000X
Also registered as: 106E00000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2019-09-26

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