Ryan Black, PA-C

NPI #1932452091 in Rigby, Idaho

Provider Information

NPI Number: 1932452091
Entity Type: Individual
Name: Ryan Black, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 25, 2012
Last Updated: Oct 24, 2023

Practice Location

Address: 703 RIGBY LAKE DR
City: Rigby
State: Idaho
ZIP Code: 83442-5192
Phone: (208) 745-0200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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