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1093281016
NICHOLAS ANDERSON
IDAHO FALLS, ID
NPI
1093281016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1788)
Enumeration Date
2018-10-17
Last Update Date
2024-06-04
Business Address
NICHOLAS ANDERSON PA-C
3200 CHANNING WAY STE 206
IDAHO FALLS, ID 83404-7546
Phone number: 208-529-2230
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Mailing Address
NICHOLAS ANDERSON PA-C
PO BOX 190930
BOISE, ID 83719-0930
Phone number: 208-367-5170
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