Derek Scott Ahlstrom, PA

NPI #1174096606 in Boise, Idaho

Provider Information

NPI Number: 1174096606
Entity Type: Individual
Name: Derek Scott Ahlstrom, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jan 8, 2019
Last Updated: Mar 28, 2024

Practice Location

Address: 7941 W RIFLEMAN ST
City: Boise
State: Idaho
ZIP Code: 83704-9001
Phone: (208) 895-7950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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