Individual
JOANNA RICHTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 LARKSPUR ST, PONDERAY, ID 83852-5011
(208) 255-3313
(208) 263-4198
Mailing address
207 LARKSPUR ST, PONDERAY, ID 83852-5011
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
N-36196
ID
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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