Individual
AMY BERASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 POLE LINE RD, SALMON, ID 83467
(208) 756-2016
(208) 756-4848
Mailing address
PO BOX 1444, SALMON, ID 83467-1444
(208) 756-2016
(208) 756-4848
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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