Individual
LAURA ANNE BARCELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
32 W 1ST S, REXBURG, ID 83440-1810
(208) 356-8883
Mailing address
636 N 2743 E, ROBERTS, ID 83444-5068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA-2037
ID
363A00000X
Physician Assistant
Primary
PA-2037
ID
Other
Enumeration date
03/11/2021
Last updated
06/17/2024
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