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1013568468
MICAH RAY TOBIN
BOISE, ID
NPI
1013568468
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1776)
Enumeration Date
2019-09-26
Last Update Date
2023-12-20
Business Address
MICAH RAY TOBIN PA
10583 W LAKE HAZEL RD
BOISE, ID 83709
Phone number: 208-302-5950
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Mailing Address
MICAH RAY TOBIN PA
PO BOX 190930
BOISE, ID 83719-0930
Phone number: 208-367-5170
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