Individual
DORIS FAYE THORNOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
444 N 10TH ST, MONTPELIER, ID 83254-1115
(208) 847-2623
Mailing address
444 N 10TH ST, MONTPELIER, ID 83254-1115
(208) 847-2623
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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