Individual
MR. JULIAN KEITH LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MOUNTAIN HOME AFB, 90 HOPE DR. BLDG 6000/366 MED GP/AMDS/SGPF, MOUNTAIN HOME, ID 83648
(208) 828-7401
Mailing address
1285 OWYHEE CT, MOUNTAIN HOME, ID 83647-1925
(208) 590-4890
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/22/2009
Last updated
07/22/2009
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