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1386933513
LAURA POLY
BOISE, ID
NPI
1386933513
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-895)
Enumeration Date
2011-03-28
Last Update Date
2022-02-25
Business Address
LAURA POLY PA
500 W FORT ST # 111
BOISE, ID 83702-4599
Phone number: 208-422-1325
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Mailing Address
LAURA POLY PA
500 W FORT ST # 111
BOISE, ID 83702-4599
Phone number: 208-422-1325
Copy
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