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1154971174
EMILY GRACE BOND RUSSELL
NAMPA, ID
NPI
1154971174
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Former Name
EMILY GRACE BOND
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2563)
Enumeration Date
2019-09-12
Last Update Date
2023-12-15
Business Address
EMILY GRACE BOND RUSSELL PA-C
9850 W ST LUKES DR # 329
NAMPA, ID 83687-7912
Phone number: 208-514-2509
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Mailing Address
EMILY GRACE BOND RUSSELL PA-C
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-514-2500
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