Individual
MYCHAELA MARIE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
578 E RIDGESTONE DR, KUNA, ID 83634-3457
(208) 340-1288
Mailing address
578 E RIDGESTONE DR, KUNA, ID 83634-3457
(208) 340-1288
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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