Individual
MRS. SHERRI STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2862 BUNGALOW DR, IDAHO FALLS, ID 83401-6011
(208) 528-8262
(208) 528-8262
Mailing address
2862 BUNGALOW DR, IDAHO FALLS, ID 83401-6011
(208) 528-8262
(208) 528-8262
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
ID
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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