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Individual

MRS. ROSE MARIE RAUBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.A

Contact information

Practice address
120 E HOWARD ST, DRIGGS, ID 83422-5112
(208) 354-3128
Mailing address
375 BUSTLE CREEK ROAD, ALTA, WY 83414-4505
(307) 353-2929

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA390
ID

Other

Enumeration date
05/09/2007
Last updated
07/08/2007
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