NPI 1730254285

Jay T Thiemann, ST

Practitioner Surgical Technologist Moscow, ID

Practice location

Address: 623 S Main St Suite 6, Moscow, ID 83843-2983
Phone: (208) 883-2828
Fax: (208) 882-2179

Registered specialties

Surgical Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZS0410X Licence ST00002460 (WA)

Other Specialist/Technologist, Other providers in Idaho →

Registry record

NPI: 1730254285
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Nov 2006
Record last updated: 8 Jul 2007

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.