Individual
KATIE LIVERMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 VASSAR WAY, IDAHO FALLS, ID 83402-3203
(208) 542-0863
Mailing address
711 VASSAR WAY, IDAHO FALLS, ID 83402-3203
(208) 542-0863
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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