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Individual

JEROLD CANTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CFNP

Contact information

Practice address
801 N STILSON RD, BOISE, ID 83703
(208) 344-7799
(208) 344-7152
Mailing address
801 N STILSON RD, BOISE, ID 83703
(208) 344-7799
(208) 344-7152

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP158
ID

Other

Enumeration date
06/08/2006
Last updated
07/09/2007
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