BRADLEY JAMES HENINGER

FRUITLAND, ID
NPI1205103389
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  PA-1026)
Additional Taxonomies363AM0700X Physician Assistant, Medical
Enumeration Date2011-11-17
Last Update Date2016-02-17
Business Address
Mr. BRADLEY JAMES HENINGER PA-C
910 NW 16TH STREET STE 205
FRUITLAND, ID 83619
Phone number: 208-452-3111
Mailing Address
Mr. BRADLEY JAMES HENINGER PA-C
3340 E GOLDSTONE WAY
MERIDIAN, ID 83642-1026
Phone number: 208-452-3111