Individual
JOHN LAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4360 N HERITAGE VIEW AVE, MERIDIAN, ID 83646-6040
(208) 861-5627
Mailing address
4360 N HERITAGE VIEW AVE, MERIDIAN, ID 83646
(208) 861-5627
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
LRT-1070
ID
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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