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1205959756
TIFFANY C COUGHENOUR
IDAHO FALLS, ID
NPI
1205959756
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA244)
Enumeration Date
2007-04-09
Last Update Date
2016-09-13
Business Address
-- TIFFANY C COUGHENOUR PA
3200 CHANNING WAY STE 205
IDAHO FALLS, ID 83404-7546
Phone number: 208-535-4300
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Mailing Address
-- TIFFANY C COUGHENOUR PA
2985 CORTEZ AVE STE 200
IDAHO FALLS, ID 83404-7554
Phone number: 208-535-4300
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