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1013952761
SIS E OSTOLASA
MERIDIAN, ID
NPI
1013952761
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA386)
Enumeration Date
2006-06-17
Last Update Date
2016-11-15
Business Address
-- SIS E OSTOLASA PA
3025 W CHERRY LANE STE B
MERIDIAN, ID 83642
Phone number: 208-302-6450
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Mailing Address
-- SIS E OSTOLASA PA
3340 E GOLDSTONE WAY
MERIDIAN, ID 83642
Phone number: 208-302-6450
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