Individual
LAURA GISELLE RUIZ-BERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 S MAIN ST, PAYETTE, ID 83661-2853
(208) 405-0020
Mailing address
12874 ALICIA ST, CALDWELL, ID 83607-5035
(208) 695-8599
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/12/2021
Last updated
06/12/2021
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