Individual
TYSON CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HIS
Contact information
Practice address
1970 E 17TH ST, IDAHO FALLS, ID 83404-8014
(866) 935-9487
(208) 542-1112
Mailing address
1970 E 17TH ST, IDAHO FALLS, ID 83404-8014
(866) 935-9487
(208) 542-1112
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA-4152
ID
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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