Individual
MS. CARLA ROXANN WOLFRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
204 E SUPERIOR ST, SUITE #9, SANDPOINT, ID 83864-1275
(208) 255-5577
(208) 255-5577
Mailing address
204 E SUPERIOR ST, SUITE #9, SANDPOINT, ID 83864-1275
(208) 255-5577
(208) 255-5577
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD9
ID
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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