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1093103699
TARA POWELL
IDAHO FALLS, ID
NPI
1093103699
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-1198)
Enumeration Date
2015-01-05
Last Update Date
2015-01-05
Business Address
-- TARA POWELL PA-C
2730 CHANNING WAY
IDAHO FALLS, ID 83404-5049
Phone number: 208-542-7100
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Mailing Address
-- TARA POWELL PA-C
2730 CHANNING WAY
IDAHO FALLS, ID 83404-5049
Phone number: 208-542-7100
Copy
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