Individual
ALEXANDRIA NOEL STAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1900 MAIN ST STE A, KLAMATH FALLS, OR 97601-2629
(541) 382-5712
Mailing address
6394 S SOLAR WAY, BOISE, ID 83709-8605
(541) 281-9022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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