TANNER D MITTON

POCATELLO, ID
NPI1144601865
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-1262)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2015-06-18
Last Update Date2017-04-26
Business Address
-- TANNER D MITTON PA-C
950 HOSPITAL WAY STE A
POCATELLO, ID 83201-2762
Phone number: 208-478-4522
Mailing Address
-- TANNER D MITTON PA-C
950 HOSPITAL WAY STE A
POCATELLO, ID 83201-2762
Phone number: 208-478-4522
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