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General NPI Number Information
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NPI Number | 1063958643
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Entity Type | Individual
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Provider Name | WENDY HUNTER
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Gender | Female
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 3100 CHANNING WAY
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7533
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Country | US
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Telephone | 208-529-6147
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Fax | 208-529-7061
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Provider Business Mailing Address
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Address Line | 2274 OAK TRAIL DR
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City | IDAHO FALLS
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State | ID
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Zip | 83404-6350
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Country | US
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Telephone | 208-313-0849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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