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1013342468
POLINA KOKOULINA
BOISE, ID
NPI
1013342468
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: ID PA-1093)
Enumeration Date
2013-09-04
Last Update Date
2015-04-06
Business Address
-- POLINA KOKOULINA PA-C
900 N LIBERTY ST STE 101
BOISE, ID 83704-8704
Phone number: 208-367-5050
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Mailing Address
-- POLINA KOKOULINA PA-C
3340 E GOLDSTONE WAY
MERIDIAN, ID 83642-1026
Phone number: 208-367-5050
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