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Individual

MARGARITA ANGELINA SWALLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1071 RENEE AVE, POCATELLO, ID 83201-2508
(208) 233-1411
(208) 233-1515
Mailing address
3608 JASON AVE, POCATELLO, ID 83204-2041
(208) 427-5459

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
54640
ID

Other

Enumeration date
03/10/2022
Last updated
03/10/2022
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