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1316677594
JUSTIN DEAN JUDKINS
POCATELLO, ID
NPI
1316677594
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2579)
Enumeration Date
2022-06-12
Last Update Date
2023-11-01
Business Address
JUSTIN DEAN JUDKINS
777 HOSPITAL WAY
POCATELLO, ID 83201-5175
Phone number: 208-239-1000
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Mailing Address
JUSTIN DEAN JUDKINS
921 S 8TH AVE STOP 8253
POCATELLO, ID 83209-0002
Phone number: 208-282-4726
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