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Individual

LINDA KRYSTLE MORALES OVERTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CST

Contact information

Practice address
1828 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-5036
(208) 381-0262
Mailing address
3636 W PALOUSE ST, BOISE, ID 83705-3244

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Enumeration date
12/17/2018
Last updated
12/17/2018
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