NPI 1427763499

Robert W Mingus, DRIVER

Practitioner Private Vehicle Clearwater, ID

Practice location

Address: 126 Shira Rd, Clearwater, ID 83552-5044
Phone: (208) 926-0894

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence WA122376H (ID)

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Registry record

NPI: 1427763499
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jan 2023
Record last updated: 13 Jan 2023

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.