Johnathon Chase Wilde, PA-C
NPI #1073231999 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1073231999
- Entity Type
- Individual
- Name
- Johnathon Chase Wilde, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Aug 16, 2022
- Last Updated
- Sep 26, 2024
Practice Location
- Address
- 3820 CRESTWOOD LN
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-4979
- Phone
- (208) 552-7700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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