Individual
HUNTER ANTHONY GOODENOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-3341
Mailing address
340 ROSE AVE, SODA SPRINGS, ID 83276-1250
(208) 589-3963
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
66348
ID
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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