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Individual

DATHAN J SPINNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDMT

Contact information

Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7401
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7401

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
06/23/2010
Last updated
05/13/2022
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