Organization
STUART GALL CRNA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART GALL (DIRECTOR)
(208) 304-3128
Entity
Organization
Contact information
Practice address
30544 HIGHWAY 200, SUITE 201, PONDERAY, ID 83852-5005
(208) 304-3128
Mailing address
PO BOX 591, SAGLE, ID 83860-0591
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-733A
ID
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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