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1255315974
LANA BORGHOLTHAUS
POCATELLO, ID
NPI
1255315974
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA590)
Enumeration Date
2005-12-06
Last Update Date
2009-02-24
Business Address
LANA BORGHOLTHAUS PA
465 MEMORIAL DR
POCATELLO, ID 83201-4008
Phone number: 208-282-4700
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Mailing Address
LANA BORGHOLTHAUS PA
465 MEMORIAL DR
POCATELLO, ID 83201-4008
Phone number: 208-282-4700
Copy
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