Individual
MARY ROSE FAY STANDLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-2222
Mailing address
305 E JEFFERSON ST, BOISE, ID 83712-6231
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
$$$$$$$$$
ID
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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