JACESON BANHAM

IDAHO FALLS, ID
NPI1295544344
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  8671842)
Enumeration Date2025-01-03
Last Update Date2026-06-08
Business Address
JACESON BANHAM PA-C
1957 E 17TH ST
IDAHO FALLS, ID 83404-6429
Phone number: 208-523-1100
Mailing Address
JACESON BANHAM PA-C
1957 E 17TH ST
IDAHO FALLS, ID 83404-6429
Phone number: 208-523-1100
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