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Individual

MR. MICHAEL WILLIAM STANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPSGT, RST, NCMA

Contact information

Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
619 N STANLEY ST, BOISE, ID 83706-2029
(208) 761-4930

Taxonomy

Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
PSG-080
ID

Other

Enumeration date
08/07/2015
Last updated
08/07/2015
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