JOHNATHON CHASE WILDE

IDAHO FALLS, ID
NPI1073231999
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  8361377)
Enumeration Date2022-08-16
Last Update Date2024-09-26
Business Address
JOHNATHON CHASE WILDE PA-C
3820 CRESTWOOD LN
IDAHO FALLS, ID 83404-4979
Phone number: 208-552-7700
Mailing Address
JOHNATHON CHASE WILDE PA-C
3820 CRESTWOOD LN
IDAHO FALLS, ID 83404-4979
Phone number: 208-552-7700
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