Individual
MISS MARY WHALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1350
(208) 422-1332
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1350
(208) 422-1332
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
Primary
—
—
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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