| Doctor Name: | MR. MICHAEL WILLIAM STANTON |
| NPI Number: | 1447636998 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPSGT, RST, NCMA |
| License Number: | PSG-080 |
| Business Practice Address: | 500 W Fort St Boise, ID - 837024501 |
| Business Phone Number: | 2084221000 |
| Business Fax Number: | |
| Mailing Address: | 619 N Stanley St, BOISE |
| State: | ID |
| Postal Code: | 837062029 |
| Phone Number: | 2087614930 |
| Fax Number: | |
| NPI Enumeration Date: | 08/07/2015 |
| NPI Last Update Date: | 08/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225500000X |
| License Number: | PSG-080 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |