TANNER D MITTON

BLACKFOOT, 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 Date2026-06-30
Business Address
TANNER D MITTON PA-C
1355 PARKWAY DR STE A
BLACKFOOT, ID 83221-1656
Phone number: 986-275-0003
Mailing Address
TANNER D MITTON PA-C
1355 PARKWAY DR STE A
BLACKFOOT, ID 83221-1656
Phone number: 986-275-0003
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