Individual
MR. DARREN D WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 POLE LINE RD, POCATELLO, ID 83201-6110
(208) 269-7150
Mailing address
5312 CANTERBURY ST, POCATELLO, ID 83202-5191
(208) 339-2229
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M8067932
—
ID
Enumeration date
02/11/2019
Last updated
02/11/2019
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