Individual
MR. REX O UNDERWOOD II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
13900 S PLEASANT VALLEY RD, KUNA, ID 83634-2723
(208) 333-0037
Mailing address
13900 S PLEASANT VALLEY RD, KUNA, ID 83634-2723
(208) 333-0037
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
59203
ID
Other
Enumeration date
02/17/2011
Last updated
04/27/2020
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