Idaho Surgical Assistants Pllc

NPI #1225389414 in Boise, Idaho

Provider Information

NPI Number: 1225389414
Entity Type: Organization
Organization Name: Idaho Surgical Assistants Pllc
Primary Specialty: Physician Assistant
Enumeration Date: Sep 27, 2012
Last Updated: Sep 27, 2012

Practice Location

Address: 190 E BANNOCK ST
City: Boise
State: Idaho
ZIP Code: 83712-6241
Phone: (208) 381-2185

Authorized Official

Name: REANNA PARK
Title: BILLING SPECIALIST
Phone: (208) 525-2090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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