Individual
SHAWNA DURBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-3722
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-3722
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D-472
ID
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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