NPI 1164988663

Edie Lustig

Practitioner Private Vehicle Grangeville, ID

Practice location

Address: 711 N State St, Grangeville, ID 83530-1650
Phone: (208) 507-2160

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence WA116016B (ID)

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Registry record

NPI: 1164988663
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Feb 2019
Record last updated: 20 Feb 2019

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.