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1104044247
DAVID M LANDIS
BOISE, ID
NPI
1104044247
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA165)
Enumeration Date
2007-04-23
Last Update Date
2014-01-15
Business Address
-- DAVID M LANDIS PA-C
703 S AMERICANA BLVD STE 130
BOISE, ID 83702-5099
Phone number: 208-706-7500
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Mailing Address
-- DAVID M LANDIS PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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