Individual
DANIEL HAWK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
369 N MIRA AVE, STAR, ID 83669-5423
(208) 890-9316
Mailing address
369 N MIRA AVE, STAR, ID 83669-5423
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
CFH-5211
ID
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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