Individual
KEISCH ANN EXNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
8475 N GOVERNMENT WAY, SUITE 103, HAYDEN, ID 83835-8670
(208) 762-6772
Mailing address
PO BOX 36, CAREYWOOD, ID 83809-0036
(425) 870-7777
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
512452-06
WA
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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