Individual
RYAN HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5243 STEELE AVE, IONA, ID 83427-0483
(208) 589-6258
Mailing address
PO BOX 483, IONA, ID 83427-0483
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/26/2012
Last updated
03/03/2017
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