Individual
MRS. STEPHANIE DAWN DAVIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRTT
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
16804 FARMWAY RD, CALDWELL, ID 83607-9670
(208) 455-3537
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
5411880-5701
UT
227800000X
Certified Respiratory Therapist
Primary
LRT-192
ID
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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