Most Relevant Information
Provider Data
| NPI Number: | 1003208638 |
| Provider Name: | VICKEY SCHMADEKA |
| Entity Type: | Individual |
| Taxonomy Code: | 171W00000X |
| Specialty: | Contractor |
| License Number: | MAS-2130 |
Most Important Dates
| Enumeration Date: | 02/18/2015 |
| Last Updated: | 02/18/2015 |
Provider Practice Location
8565 W STONEHAVEN ST
BOISE
ID
837047079
Practice Location Phone/Fax
| Phone: | 5418050028 |
| Fax: |
Provider Mailing Location
8565 W STONEHAVEN ST
BOISE
ID
837047079
Provider Mailing Phone/Fax
| Phone: | 5418050028 |
| Fax: |