Individual
MICHAEL RAY CERCHIONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2007 E QUAIL RUN RD # 2, EMMETT, ID 83617-5059
(208) 365-2525
(208) 365-2234
Mailing address
2007 E. QUAIL RUN ROAD, #2, EMMETT, ID 83617
(208) 949-4479
(208) 365-2234
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
L-2382
ID
Other
Enumeration date
08/26/2011
Last updated
08/26/2011
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