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Ms. Carolyn Diane Swan
Home Modifications Contractor in Juliaetta, Idaho
NPI 1649439373

Carolyn Diane Swan is a Home Modifications Contractor based in Juliaetta, ID and is specialized in Home Modifications. Carolyn Diane Swan practices in Juliaetta, ID. The NPI Number for Carolyn Diane Swan is 1649439373 and holds a License No. CFH20165 (Idaho).

The current practice location address for Carolyn Diane Swan is 417 Main St, Juliaetta, ID and can be reached out via phone at 208-276-3174.

Location: 417 Main St, Juliaetta, ID, 83535-5003
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649439373
Provider Name
Carolyn Diane Swan
Credential
Provider Entity Type
Individual
Gender
Female
Address
417 Main St, Juliaetta, ID, 83535-5003
Phone Number
208-276-3174
Fax Number
Provider Enumeration Date
06/06/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
807843600 05 ID
institution
Provider Business Practice Location Address Details
Address
417 Main St
City
Juliaetta
State
Idaho
Zip
83535-5003
Phone Number
208-276-3174
Fax Number
person
Provider Business Mailing Address Details
Address
417 Main St
City
Juliaetta
State
Idaho
Zip
83535-5003
Phone Number
208-276-3174
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Contractor
Speciality
Home Modifications
Taxonomy
171WH0202X
License No.
CFH20165 (Idaho)
Definition
Definition to come...
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