Individual
CLAUDIA JAE BERMENSOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
2101 S MANITOU AVE, BOISE, ID 83706-4150
(208) 591-0005
Mailing address
2101 S MANITOU AVE, BOISE, ID 83706-4150
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
LRT-2228
ID
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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