County of Canyon School District Class B 136j

Practice location

Address

520 Broadway Ave, Melba, ID 83641

Phone

(208) 495-1141

Fax

(208) 495-1142

Mailing address

176 E Calderwood Dr STE 100, Meridian, ID 83642-9097

Authorised official

Name

Todd Kenneth Levesque

Title

Systems Manager

Phone

(208) 922-3093

Registered specialties

Registry record

NPI

1053458547

Entity type

Organization

NPI issued

31 Jan 2007

Record last updated

13 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.