Individual
JAMES FORREST FAUVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24648 GOLDEN LN, LEWISTON, ID 83501-7964
(208) 790-4504
Mailing address
24648 GOLDEN LN, LEWISTON, ID 83501-7964
(208) 790-4504
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
CFH-9384
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9384
—
ID
Enumeration date
02/03/2022
Last updated
02/03/2022
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