Individual
SALLY ANN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 JACHETTA RD, PRIEST RIVER, ID 83856-6782
(208) 610-0481
Mailing address
311 JACHETTA RD, PRIEST RIVER, ID 83856-6782
(208) 610-0481
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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