Organization
NATIONWIDEBATH COM LLC
Active
Other names
Treasure Valley Fiberglass Repair, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KLAUS E RUTTKE (MANAGING MEMBER/OWNER)
(208) 939-1595
Entity
Organization
Contact information
Practice address
647 S STIBNITE AVE, KUNA, ID 83634-1992
(208) 939-1595
(208) 939-1595
Mailing address
PO BOX 50122, BOISE, ID 83705-0963
(208) 939-1595
(208) 939-1595
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
10/28/2011
Last updated
11/08/2011
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