Individual
KATHERINE GRIJALVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12899 FINCH LN, MIDDLETON, ID 83644-5194
(208) 250-8629
Mailing address
12899 FINCH LN, MIDDLETON, ID 83644-5194
(208) 250-8629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F09240265
ID
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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