Breanna Carlos

NPI #1124504337 in Pocatello, Idaho

Provider Information

NPI Number: 1124504337
Entity Type: Individual
Name: Breanna Carlos
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jul 11, 2018
Last Updated: Jul 11, 2018

Practice Location

Address: 1169 CALL CREEK DR
City: Pocatello
State: Idaho
ZIP Code: 83201-3077
Phone: (202) 232-7780

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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