Individual
MR. ROBERT ERNEST TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
823 TAMARACK DR APT 104, LEWISTON, ID 83501-4734
(208) 541-4611
Mailing address
823 TAMARACK DR APT 104, LEWISTON, ID 83501-4734
(208) 541-4611
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
—
—
347C00000X
Private Vehicle
Primary
YC366228D
ID
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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