Most Relevant Information
Provider Data
| NPI Number: | 1003450107 |
| Provider Name: | MERIA REUSSER CPRP |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/31/2019 |
| Last Updated: | 10/31/2019 |
Provider Practice Location
314 BADIOLA ST
CALDWELL
ID
836054389
Practice Location Phone/Fax
| Phone: | 2084548389 |
| Fax: | 2084548404 |
Provider Mailing Location
314 BADIOLA ST
CALDWELL
ID
836054389
Provider Mailing Phone/Fax
| Phone: | 2084548389 |
| Fax: | 2084548404 |