CODY JOHNSON

BOISE, ID
NPI1184392011
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2399)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2021-09-03
Last Update Date2022-11-30
Business Address
CODY JOHNSON
190 E BANNOCK ST FL 10
BOISE, ID 83712-6241
Phone number: 208-381-5500
Mailing Address
CODY JOHNSON
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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