Organization
DORIS THORNOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS F THORNOCK (SOLE PROPRIETOR)
(208) 847-2623
Entity
Organization
Contact information
Practice address
444 N 10TH ST, MONTPELIER, ID 83254-1115
(208) 847-2623
Mailing address
444 N 10TH ST, MONTPELIER, ID 83254-1115
(208) 847-2623
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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