Most Relevant Information
Provider Data
| NPI Number: | 1003461401 |
| Provider Name: | NOAH BERNAL |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/03/2019 |
| Last Updated: | 08/21/2024 |
Provider Practice Location
3614 WASHINGTON PKWY
IDAHO FALLS
ID
834047573
Practice Location Phone/Fax
| Phone: | 2085354343 |
| Fax: |
Provider Mailing Location
6410 E MANSION HILL DR
AMMON
ID
834064707
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |