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MATTHEW ALAN HENSLEE COTA

Nursing/Intermediate Care Facility

Boise, Idaho

Provider NPI: 1558579979

Provider Information:
 MATTHEW ALAN HENSLEE COTA


Practice Location:
1130 ALLUMBAUGH ST  BOISE, ID 83704 US
Tel: 208-854-8517  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
IDOTA185





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