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1104394337
LUCAS P BELFORD
BLACKFOOT, ID
NPI
1104394337
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1676)
Enumeration Date
2018-11-06
Last Update Date
2023-09-21
Business Address
LUCAS P BELFORD PA
700 E ALICE ST
BLACKFOOT, ID 83221-4925
Phone number: 208-785-1200
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Mailing Address
LUCAS P BELFORD PA
909 E RESERVE ST
BOISE, ID 83712-6508
Phone number: 502-544-1780
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