Individual
CORY JAMES SAYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221
(208) 785-3830
Mailing address
PO BOX 946, BLACKFOOT, ID 83221-0946
(208) 552-8778
(208) 523-2025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
56065
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821528084
—
ID
Enumeration date
06/19/2017
Last updated
10/09/2018
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