Individual
CHARLES W RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L AC.
Contact information
Practice address
3607 W KOOTENAI ST, BOISE, ID 83705-2250
(208) 388-1171
Mailing address
3607 W KOOTENAI ST, BOISE, ID 83705-2250
(208) 388-1171
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-16
ID
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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