Individual
MAKELL BRUGGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
323 E RIVERSIDE DR, SUITE 234, EAGLE, ID 83616-6864
(208) 938-4080
(208) 938-8922
Mailing address
323 E RIVERSIDE DR, SUITE 234, EAGLE, ID 83616-6864
(208) 938-4080
(208) 938-8922
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
96662
ID
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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