TYLER JORDAN POND

AMMON, ID
NPI1356844500
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-1590)
Enumeration Date2018-03-14
Last Update Date2018-03-14
Business Address
TYLER JORDAN POND PA-C
2705 E 17TH ST
AMMON, ID 83406-6601
Phone number: 208-346-7500
Mailing Address
TYLER JORDAN POND PA-C
2705 E 17TH ST
AMMON, ID 83406-6601
Phone number: 208-346-7500