Individual
MRS. AMIE LEE STORM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
8166 E BUNCO RD, ATHOL, ID 83801-5294
(208) 704-5074
Mailing address
8166 E BUNCO RD, ATHOL, ID 83801-5294
(208) 704-5074
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MID-81
ID
Other
Enumeration date
07/11/2012
Last updated
11/18/2023
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