Edie Lustig

NPI #1164988663 in Grangeville, Idaho

Provider Information

NPI Number: 1164988663
Entity Type: Individual
Name: Edie Lustig
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Private Vehicle
Enumeration Date: Feb 20, 2019
Last Updated: Feb 20, 2019

Practice Location

Address: 711 N STATE ST
City: Grangeville
State: Idaho
ZIP Code: 83530-1650
Phone: (208) 507-2160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Private Vehicle	347C00000X	Primary

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