Individual
MR. MARK JAMES WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
4700 N CLOVERDALE RD, SUITE #213, BOISE, ID 83713-1081
(208) 377-0109
Mailing address
4700 N CLOVERDALE RD, SUITE #213, BOISE, ID 83713-1081
(208) 377-0109
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA-269
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669601209
—
ID
Enumeration date
08/24/2011
Last updated
08/24/2011
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