Individual
DANIEL E CLOETINGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(484) 678-6367
Mailing address
109 EVERGREEN DR, DOWNINGTOWN, PA 19335-1012
(484) 678-6367
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
M-13713
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2012
Last updated
10/20/2020
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