Individual
LETICIA CRUZ PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
870 EDEN DR, IDAHO FALLS, ID 83401-3660
(208) 701-8256
Mailing address
870 EDEN DR, IDAHO FALLS, ID 83401-3660
(208) 701-8256
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
ID00037138E
ID
376K00000X
Nurse's Aide
Primary
ID00037138E
ID
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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