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1174980346
RYAN WILSON
MERIDIAN, ID
NPI
1174980346
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1341)
Enumeration Date
2016-01-19
Last Update Date
2022-06-16
Business Address
RYAN WILSON PA
1623 S WELLS AVE
MERIDIAN, ID 83642-5040
Phone number: 208-489-1450
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Mailing Address
RYAN WILSON PA
PO BOX 191050
BOISE, ID 83719-1050
Phone number: 208-955-6500
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