Individual
LORI PALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
402 ELM STREET, MACKAY, ID 83251
(208) 588-2302
Mailing address
PO BOX 52, MACKAY, ID 83251-0052
(208) 588-2302
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0001613
—
ID
Enumeration date
08/28/2016
Last updated
08/28/2016
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