Individual
DAVID L STAHLECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
629 N HARRISON AVE, POCATELLO, ID 83204-2935
(208) 232-9468
Mailing address
206 N ARTHUR AVE, POCATELLO, ID 83204-3104
(208) 232-9468
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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