Individual
RANDALL BRADFORD CHOKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
229 S 7TH ST, ST MARIES, ID 83861-1803
(208) 245-5551
(208) 245-5246
Mailing address
229 S 7TH ST, ST MARIES, ID 83861-1803
(208) 245-5551
(208) 245-5246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60291455
WA
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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