Individual
CECIL GAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
823 HARRISON ST, TWIN FALLS, ID 83301
(208) 736-2177
Mailing address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CPSS074
ID
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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