Individual
MARY JOSARA WALLBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
921 S 8TH AVE STOP 8116, POCATELLO, ID 83201-5377
(208) 282-3828
Mailing address
921 S 8TH AVE STOP 8116, POCATELLO, ID 83201-5377
(208) 282-3828
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD-1382
ID
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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