Individual
REECE ARTHUR BODAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 W MAIN ST, EMMETT, ID 83617-2937
(208) 369-4307
(208) 369-4503
Mailing address
211 W MAIN ST, EMMETT, ID 83617-2937
(208) 369-4307
(208) 369-4307
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3160
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA3160
STATE LICENSE
ID
Enumeration date
11/19/2019
Last updated
08/06/2020
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