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Chess Carbol
NPI 1760927834 · on the registry since 2016
Practice
- Address
- 1578 Mountain Shadow Dr
Pocatello, ID 83204 - Phone
- (208) 220-1369
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-12-28
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