Individual
THOMAS WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HOUSING PROVIDER
Contact information
Practice address
212 6TH AVE W, JEROME, ID 83338-1834
(208) 316-4881
Mailing address
PO BOX 749, JEROME, ID 83338-5483
(208) 316-4881
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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