Lisa A Bosworth, PA

NPI #1730372756 in Pocatello, Idaho

Provider Information

NPI Number: 1730372756
Entity Type: Individual
Name: Lisa A Bosworth, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Aug 22, 2007
Last Updated: Feb 14, 2024

Practice Location

Address: 1951 BENCH RD STE B
City: Pocatello
State: Idaho
ZIP Code: 83201-2073
Phone: (208) 238-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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