Michael Allan Hallstrom, PA-C

NPI #1972950210 in Boise, Idaho

Provider Information

NPI Number: 1972950210
Entity Type: Individual
Name: Michael Allan Hallstrom, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 17, 2016
Last Updated: Mar 17, 2018

Practice Location

Address: 190 E BANNOCK ST
City: Boise
State: Idaho
ZIP Code: 83712-6241
Phone: (208) 381-5015

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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