Individual
MRS. SANDRA BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
2860 CHANNING WAY STE 102, IDAHO FALLS, ID 83404-7532
(208) 529-6127
(208) 529-7372
Mailing address
2860 CHANNING WAY STE 102, IDAHO FALLS, ID 83404-7532
(208) 529-6127
(208) 529-7372
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-365
ID
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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